Questions - Answers~2.xlsx
XLSX spreadsheet 22 KB Posted
- Attached to
- Actuarial Services State and local contract opportunity
- Solicitation number
- 40DHHS-S3339
- Issued by
- Clark County, Nevada
About this file
The file is a Questions and Answers (Q&A) Excel spreadsheet for the Nevada Department of Health and Human Services Division of Health Care Financing and Policy's Actuarial Services Request for Proposal (RFP) 40DHHS-S3339. The RFP seeks actuarial services for three distinct scopes of work: Managed Care Organization (MCO) and Dental Benefits Administrator (DBA) Capitation Rate Setting, Specialty MCO for Children with Complex Behavioral Health Needs, and Non-Emergency Medical Transportation (NEMT) Rate Setting. The procurement covers services for Nevada Medicaid and Nevada Check-Up, serving approximately 793,904 participants. The critical submission deadline is July 8, 2025, at 2:00 PM PST, with an anticipated contract award on September 9, 2025. The contract will have a five-year term with potential two-year extensions, initially covering Calendar Year 2027 and potentially expanding to include 75,000 rural residents.
The Q&A document reveals key pricing and operational details, including a resource pool for ad-hoc reporting with hourly rate structures for various professional levels. Vendors are not required to bid on all three scopes of work, and the state does not anticipate increasing the number of MCOs, DBA plans, Specialty MCOs, or NEMT brokers. The evaluation will be weighted 85% for technical proposals and 10% for cost, with potential vendor presentations influencing selection. The state will provide actuarial data annually and as needed for special projects, and vendors can propose annual inflationary adjustments to hourly rates. The procurement emphasizes developing actuarially sound capitation rates and supporting innovative healthcare financing initiatives, with the state preferring vendors to use cloud service models and SFTP sites for data transfer.
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Other files for this state and local contract opportunity
| File | Type | Posted |
|---|---|---|
| 40DHHS-S3339 - BAA Global DHHS August 2024.docx | DOCX document | |
| Standard-form-contract~9.docx | DOCX document | |
| 40DHHS-S3339 - Caseload Projections with Retros.xlsx | XLSX spreadsheet | |
| 40DHHS-S3339 - Insurance Schedule - RFP.pdf | ||
| Terms-and-conditions-for-services~9.pdf | ||
| 40DHHS-S3339 - Cost Schedules MCO-DBA Specialty MCO NEMT~1.xlsx | XLSX spreadsheet | |
| 40DHHS-S3339 -Reference-Questionnaire-2025-05-07~1.pdf | ||
| 40DHHS-S3339-RFP Actuarial Services.docx | DOCX document | |
| Quote Instructions.pdf | ||
| 40DHHS-S3339 - DHCFP Business Continuity Agreement_v2.docx | DOCX document | |
| 40DHHS-S3339 - Scopes of Work.docx | DOCX document | |
| Certification-regarding-lobbying~9.pdf | ||
| Vendor Information Response.pdf |
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Text version
Bid Q&A for Export Report
| Bid Q&A | |||||
| QUESTION_NBR | CREATED_BY | QUESTION_SUBJECT | QUESTION_TEXT | ANSWER_TEXT | |
| 1 | MERCERGHSC | MMIS | Will the State provide the actuarial vendor(s) with complete and accurate claims, encounter, and eligibility data directly from the Stateâ??s MMIS to support the scopes of work in this RFP? | Yes, the state requests reviewed and approved final file formats to complete the requests. | |
| 2 | MERCERGHSC | States Data | How often will the State provide complete and accurate data to the actuarial vendor(s) to complete the scopes of work (e.g., annually)? | Yes, annually and as needed for any special projects as approved by the state. | |
| 3 | MERCERGHSC | Limitation of Liability | Will the State consider negotiating mutually acceptable limitation of liability language for services rendered under this contract? | This will have to be reviewed and determined by the Deputy Attorney General. | |
| 4 | MERCERGHSC | Cost Schedule | The Cost Schedule for the MCO/DBA SOW #1 has risk adjustment and risk mitigation listed in both task areas B and D. For pricing purposes, can the State please clarify the difference between task areas B and D in the SOW #1 Cost Schedule? | Risk Adjustment would include use of the CDPS + Rx risk adjustment model to adjust capitation payments. While Risk mitigation would include strategies like risk corridors. | |
| 5 | MERCERGHSC | Ad Hoc Resource Pool | For the Proposed Resource Pool, the cost sheet requires vendors to provide annual hours. Since Resource Pool ad hoc work is difficult to predict and may change significantly from year-to-year based on the Stateâ??s needs, does the State have a maximum annual number of hours allocated for Ad Hoc Resource Pool work that vendors can be required to use to normalize this part of the cost proposal? | No Maximum | |
| 6 | MERCERGHSC | Resource Pool | For the Proposed Resource Pool, the cost sheet requires vendors to provide hourly rates by labor category, but also to provide a weighted average composite hourly rate. For any approved Resource Pool work orders, will the vendor invoice the State based on the individual labor category rates or the weighted composite rate? Depending on the specifics of the respective Resource Pool work order, the weighting of staff may vary. | Composite Rate. | |
| 7 | MERCERGHSC | Scope of Work List | Are vendors required to submit a proposal to complete all three of the scopes of work listed in 2.9.1, 2.9.2, and 2.9.3? | No. See 2.6 and 2.7 of the RFP | |
| 8 | MERCERGHSC | Contract Award | Will the State award contracts to more than one vendor for the same SOWs #1-#3? If so, how will the work subsequently be divided among multiple vendors within the same SOW? | No. See 2.6 and 2.7 of the RFP | |
| 9 | MERCERGHSC | Resource Pool | Are vendors permitted to only bid/respond to the Resource Pool of ad hoc scope of work? | No. The Ad Hoc hours are to support the other deliverables in the SOW. | |
| 10 | MERCERGHSC | Cost Proposal Form | Are vendors permitted to specify an annual inflationary adjustment to the hourly rates listed in the Resource Pool cost proposal form? | Yes | |
| 11 | MERCERGHSC | SOW # 1 MCOs | If the State changes the number of MCOs in SOW #1, will the Actuarial Services budget be adjusted? | The State does not anticipate number of MCOs to increase. | |
| 12 | MERCERGHSC | Resource Pool | If a mid-year revision/update to one or more of the SOWsâ?? managed care capitation rates is required, will the respective mid-year rate revision be a Resource Pool project? | Yes | |
| 13 | MERCERGHSC | DBA Plans | If the State increases the number of DBA plans from the current single DBA entity, will the Actuarial Services budget be adjusted to reflect the change in the number of DBA plans? | The State does not anticipate number of DBA to increase. | |
| 14 | MERCERGHSC | SOW # 2 | If the number of Specialty MCO entities in SOW #2 changes during the course of this contract, will the Actuarial Services budget be adjusted? | The State does not anticipate number of Specialty MCO to increase. | |
| 15 | MERCERGHSC | NEMT Brokers | If the State changes the number of NEMT brokers from the current one NEMT broker entity, will the Actuarial Services budget be adjusted to reflect the change in the number of NEMT brokers? | The State does not anticipate the number of NEMT brokers to increase. | |
| 16 | MERCERGHSC | Cost Schedule SOW # 3 | The Cost Schedule for SOW #3 NEMT Actuarial Services, lists Risk Adjustment as part of task area B; however, the description of SOW #3 does not reference CDPS+Rx risk adjustment at all. Is a tool such as CDPS+Rx risk adjustment expected to be applied to NEMT capitation rates when there is a single NEMT vendor? | If there is only one vendor for NEMT then risk adjustment would not apply. | |
| 17 | MERCERGHSC | SOW #1 â?? 3 | For each SOW #1-#3 description, some of the tasks are listed as â??if deemed necessary.â?? If the Cost Schedule is based on a fixed fee arrangement, are vendors instructed to base their cost proposal on all tasks being necessary? | Yes | |
| 18 | MERCERGHSC | SOW #1 â?? 3 | For each SOW #1-#3, how many interim, mid-year rate adjustments per year does the State undertake? This will inform more accurate pricing the Cost Proposal â??cost per deliverable.â?? | For scope 1 there may be 1 mid-year adjustment needed.The State currently uses prospective risk addjustment with final rates calculated after risk adjustment is completed. For scopes 2 and 3 the State does not anticipate needing any mid-year adjustments to the rates. However, depending on Federal changes, mid-year adjustments my be needed. | |
| 19 | MERCERGHSC | SOW Item 1.6.2 | For SOW item 1.6.2, is the frequency of the encounter data monitoring annually to align with the annual rate development process? Performing encounter data comparisons can have a significant cost impact if done more frequently than annually. | Please ref to the RFP. | |
| 20 | MERCERGHSC | SOW Item 1.6.6 | For SOW item 1.6.6, is the required frequency for obtaining and monitoring encounter data â??periodicallyâ?? an annual event aligning with the annual rate development process? | Please ref to the RFP. | |
| 21 | MERCERGHSC | SOW Item 1.6.8 | What are the primary differences between the services covered by SOW item 1.6.8 and what would be considered Resource Pool Ad Hoc work? | Ad Hoc is defined in the RFP | |
| 22 | MERCERGHSC | Cost Schedule | Are vendors permitted to specify an annual inflationary adjustment to the fixed fee cost per deliverable amounts for SOW #1, SOW #2, and SOW #3 in the Cost Schedule? | All projected cost should be in the cost schedule. | |
| 23 | MERCERGHSC | SOW Item 1.5.4 | Will the additional work described in SOW item 1.5.4 be authorized through the Resource Pool? | Please ref to the RFP. | |
| 24 | MERCERGHSC | SOW #1 Item 1.6 | As it relates to SOW #1 item 1.6, what is the role of the Stateâ??s EQRO vendor to perform encounter data validation under the EQRO contract? | They perform encounter data validation for MCO and DBA vendors. | |
| 25 | MERCERGHSC | Terms and Conditions | Under the Terms and Conditions for Services document, Section 1.4, Solicitation, Subsection 1.4.3, page 1, can the State clarify â??material changesâ?? that Vendors are permitted to propose in order for the State not to deem the response as non-responsive? | Making changes to the RFP as already written. | |
| 26 | OPTUMAS74! | Actuarial Certifications | Can the State provide the most recent actuarial certification for each of the current managed care programs? | Yes the public versions of these can be provided | |
| 27 | OPTUMAS74! | Contracts | Can the State the most recent contract(s) with the current actuarial vendor(s) for each of the scopes of work? | The current contract is listed in EPro. | |
| 28 | OPTUMAS74! | Cloud Service Model | Does the State or its current actuarial vendor(s) utilize any Cloud Service Model (CSM) for the scopes of work under this RFP? | Yes, the State of Nevada utilizes various cloud service models. Nevada has transitioned to a hybrid cloud environment, leveraging both public and private cloud solutions. This includes GovCloud (a secure platform within Microsoft Azure Government) for sensitive data and the "Silver Cloud" (a state private cloud). The state also has a contract for cloud solutions through Carahsoft, enabling agencies to procure services like Software as a Service (SaaS), Platform as a Service (PaaS), and Infrastructure as a Service (IaaS). https://it.nv.gov/uploadedFiles/itnewnvgov/content/Governance/Security/FINAL_S_5_06_01_Cloud_Services.pdf | |
| 29 | OPTUMAS74! | Cloud Service | Does the State anticipate needing to utilize any Cloud Service Model (CSM) for the scopes of work under this RFP? | Yes. Please refer to Cloud Services standards here- https://it.nv.gov/uploadedFiles/itnewnvgov/content/Governance/Security/FINAL_S_5_06_01_Cloud_Services.pdf | |
| 30 | OPTUMAS74! | Hosting | In section 6.5.3 of the Scopes of Work, does the term â??hostâ?? have a specific definition, or does this apply to all cases of receiving PHI-related data from the State? If there is a specific definition, can the State provide that definition? | I assume that this is at typo | |
| 31 | OPTUMAS74! | SFTP Site | Does the State utilize their own SFTP site for transferring data to/from vendor, or should the vendor provide their own SFTP site for data transfer? | Yes the state does offer a SFTP site. We do prefer a push/pull method when possible using vendor solutions. This can be discussed more once a vendor is chosen. | |
| 32 | OPTUMAS74! | Periodic Data Monitoring | In section 1.6.6 of the Scopes of Work, can the State provide additional detail on what the periodic data monitoring may entail? | ||
| 33 | MICHAEL.COOK | Project Overview - 2.4 | Does â??may award each scope based on the highest scoring vendorâ?? imply that the award for one or more of the three independent scopes may go to the organization not having the highest score for that scope of work? | No. See 2.6 and 2.7 of the RFP | |
| 34 | MICHAEL.COOK | Cost Schedule | For cost schedule lines that may include more than one instance or deliverable (for example, multiple MCO rate modifications and risk mitigation calculations in a single year in line 9, Item B on the â??Medical MCO & DBAâ?? tab), should the cost entry be the all-inclusive cost that would cover all instances or deliverables in one year, regardless of the number of instances or deliverables for that line? | Please ref to the RFP. | |
| 35 | MICHAEL.COOK | Cost Schedule | Will rates on this tab be required to be used during the contract period to build up specific projected ad hoc project costs for vendors selected to be part of the resource pool referenced in Section 2.9.4? If so, will the blended rate or the individual position rates be used? The utilization of individuals at different Staff Professional Levels will vary commiserate with the scope and nature of the Ad Hoc service. | Please use the cost schehule to develop the blended rate. | |
| 36 | MICHAEL.COOK | Project Overview - 2.7 | Does this section imply that upon establishment of the awarded vendors, ad hoc work could be awarded to quotes based on either qualifications, low cost, or a combination of both? | Ad hoc costs will be calualate from the composite rate; see the Ad hoc tab in the RFP | |
| 37 | MICHAEL.COOK | MCO-DBA | Will the 3-month transition period be from October 2025 to December 2025 or January 2026 to March 2026? | Anticipated October 2025 - December 2025 | |
| 38 | MICHAEL.COOK | Cost Schedule | It is difficult for respondents to know how many ad hoc hours will be required under this contract. Should all respondents assume the same fixed number, such as 1,000 for scoring purposes? | Please use 1000 hours to project costs for scoring purposes. | |
| 39 | MICHAEL.COOK | Cost Schedule | Will rates or cost on this tab be used for vendor scoring? How does this reconcile with Section 2.9.4 that states, (Each vendor that receives an award under this solicitation will also receive an award to serve as a qualified vendor eligible for future contracts with the State as part of a resource pool of contracted actuarial and financial vendorsâ?¦)? | The costs will be used in scoring. | |
| 40 | MICHAEL.COOK | Work Order Form | Is the Work Order Form available for respondents to review? | This form will be provided to the awarded vendor(s) upon contract start date. | |
| 41 | MICHAEL.COOK | Vendor Information Response | The footnote of the document states that the attachment is page 1 of 4. Please confirm there are no missing pages in this attachment. | Correct. There is only one page to this document. | |
| 42 | MERCERGHSC | Vendor Experience | Can you confirm that â??vendor experience, qualifications, capacityâ?? refers to the organizational experience, capacity, qualifications of the bidding entity and should not be substituted with the individual experience of staff members gained at other entity? | Please ref to the RFP. | |
| 43 | MERCERGHSC | Technical Factor #3 | Can the Agency please clarify whether a Vendorâ??s current or prior consulting relationships with Managed Care Organizations (MCOs) operating in the Nevada Medicaid market or health insurance exchanges would be considered a direct or indirect conflict of interest under Technical Factor #3, given the potential for divided loyalty in supporting the Stateâ??s managed care programs? | Prior consulting relationships do not create a conflict. | |
| 44 | MERCERGHSC | Subcontractor | Will subcontractor experience be considered in evaluating vendor qualifications and past performance? If so, must the subcontractor be identified and contractually committed at the time of proposal submission? | Please ref to the RFP. | |
| 45 | MERCERGHSC | Technical Factors #1â??4 | Is there a specific time frame (e.g., past 3â??5 years) within which prior experience must fall in order to be considered relevant under Technical Factors #1â??4? | No Maximum | |
| 46 | MERCERGHSC | Cost Factor Scoring | Under the Cost Factor scoring, will the Agency consider only total cost, or will cost-effectiveness and value for services (e.g., technical quality per dollar) also be evaluated? | Cost will be evaluated based on the cost schedule. | |
| 47 | SALLYSMITH | â?¢ | As noted in RFP Actuarial Services section 2.6, there will be three separate evaluations on the three scopes of work. Will all evaluation criteria outlined in 6.1.6 be done separately for each of the three separate scopes of work to develop a SOW-specific rating? Can the State provide an example of how the evaluation for the three separate scopes of work will be calculated? | Evaluations will be done seperately. | |
| 48 | SALLYSMITH | â?¢ | Can the State provide historical aggregate hours, hourly rates, and total fees for the services listed in the scope of work over the past three years? As well as the estimated annual work hours for the current fixed fee scope of work broken down by deliverable listed in the Cost Schedule? | Not at this time. | |
| 49 | SALLYSMITH | â?¢ | Regarding the cost schedules attachment, the â??Specialty MCOâ?? and â??NEMTâ?? worksheet instructions say that the vendor must provide proposed hourly rates, but there is no space to populate hourly rates in the worksheet. Should deliverable entries for â??Specialty MCOâ?? and â??NEMTâ?? be quoted as a fixed fee, and therefore hourly rates do not need to be populated, or should the hourly rates be added to the cost schedule? If hourly rates are requested, will the cost scoring be based off of the total annual costs or hourly rates? | Please disregard the sentance regarding proposed hourly rates. If shoudl be fixed coast per deliverable. | |
| 50 | SALLYSMITH | Regarding the cost schedules attachment, the â??Medical MCO and DBAâ??, â??Specialty MCOâ??, and â??NEMTâ?? worksheets each have a â??Cost per Deliverableâ?? column. Is each row of the worksheet intended to be one single deliverable that occurs once annually? For example, how should this be handled when there are potentially multiple deliverables in a given year for certain items (such as in the instance of a supplemental rate package to account for program/policy changes)? | Yes. Each row is a single deliverable. | ||
| 51 | SALLYSMITH | Regarding the cost schedules attachment, the â??Proposed Resource Poolâ?? worksheet includes a line for Principal FSA and Reviewing/Managing Actuary FSA. Can these roles be performed by ASAs? SOW section 6.2.1 suggests that individuals with Fellow of the Society of Actuaries (FSA) or Associate of the Society of Actuaries (ASA), and Member of the American Academy of Actuaries (MAAA) credentials can be identified as project managers. | Those roles would not be able be provided by ASAs. | ||
| 52 | SALLYSMITH | For the Proposed Resource Pool worksheet, will the scoring be calculated on the rate by position, the composite rate, or the annual dollar rate (row 18)? | Composite per the worksheet | ||
| 53 | SALLYSMITH | For the Proposed Resource Pool worksheet, can the estimated hours to include in the Proposed Resource Pool for Hours per Year (cell G18) be provided? | Use 1000 as the estimate to calulate costs. | ||
| 54 | SALLYSMITH | Are references required? If so, 1) how many are required; 2) will the Stateâ??s Single Point of Contact provide an emailed confirmation of receipt to individuals who submit references on behalf of a vendor (i.e., to confirm that the reference was received)? | Please see 8.8.6 of the RFP. References can be confirmed with single point of contact on RFP. | ||
| 55 | SALLYSMITH | To mitigate risks associated with sensitive data transfers, is the State open to solutions of allowing vendors to access and handle PHI remotely on state servers/clouds to avoid potential data transfer risks? | Typically no. Data should be hosted on vendor approved solutions |
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