QUOTE-CONSULTANT-RURAL HEALTH TRANSFORMATION PROGRAM.docx

REQUEST FOR QUOTES (QR)

#20250728

RFX #3200001361

Consultant for the State’s Application for the Rural Health Transformation Program

Mississippi Division of Medicaid Post Office Box 2222 Jackson, Mississippi 39225

Contact:

Jeanette Crawford Jeanette.Crawford@medicaid.ms.gov

Quotes Due:

August 4, 2025, by 2:00 pm CST

Request for Quotes

INTRODUCTION

The Mississippi Division of Medicaid (DOM), in coordination with the Office of the Governor and the Mississippi State Department of Health (MSDH), is soliciting quotes from consultants to prepare the State’s Application for the Rural Health Transformation Program provided for in The One Big Beautiful Bill Act.[footnoteRef:1] [1: Public Law 119-21; House Resolution 1, Title VII, Subtitle B, Chapter 4, Section 71401.]

PROJECT OVERVIEW

In order for the State to qualify for available funding, the State must submit a detailed rural health transformation plan which must be approved by the Administrator of the Centers for Medicare and Medicaid Services (CMS) no later than December 31, 2025. The Administrator is required to specify the form and manner of application, as well as the submission period for such applications.

The application must include “a detailed rural health transformation plan--

1. to improve access to hospitals, other health care providers, and health care items and services furnished to rural residents of the State;

2. to improve health care outcomes of rural residents of the State;

3. to prioritize the use of new and emerging technologies that emphasize prevention and chronic disease management;

4. to initiate, foster, and strengthen local and regional strategic partnerships between rural hospitals and other health care providers in order to promote measurable quality improvement, increase financial stability, maximize economies of scale, and share best practices in care delivery;

5. to enhance economic opportunity for, and the supply of, health care clinicians through enhanced recruitment and training;

6. to prioritize data and technology driven solutions that help rural hospitals and other rural health care providers furnish high-quality health care services as close to a patient's home as is possible;

7. that outlines strategies to manage long-term financial solvency and operating models of rural hospitals in the State; and

8. that identifies specific causes driving the accelerating rate of stand-alone rural hospitals becoming at risk of closure, conversion, or service reduction.”

The State must submit a plan to use any allotment awarded for at least three of the following purposes:

1. Promoting evidence-based, measurable interventions to improve prevention and chronic disease management.

2. Providing payments to health care providers for the provision of health care items or services, as specified by the Administrator.

3. Promoting consumer-facing, technology-driven solutions for the prevention and management of chronic diseases.

4. Providing training and technical assistance for the development and adoption of technology-enabled solutions that improve care delivery in rural hospitals, including remote monitoring, robotics, artificial intelligence, and other advanced technologies.

5. Recruiting and retaining clinical workforce talent to rural areas, with commitments to serve rural communities for a minimum of 5 years.

6. Providing technical assistance, software, and hardware for significant information technology advances designed to improve efficiency, enhance cybersecurity capability development, and improve patient health outcomes.

7. Assisting rural communities to right size their health care delivery systems by identifying needed preventative, ambulatory, pre-hospital, emergency, acute inpatient care, outpatient care, and post-acute care service lines.

8. Supporting access to opioid use disorder treatment services (as defined in section 1861(jjj)(1)), other substance use disorder treatment services, and mental health services.

9. Developing projects that support innovative models of care that include value-based care arrangements and alternative payment models, as appropriate.

10. Additional uses designed to promote sustainable access to high quality rural health care services, as determined by the Administrator.

The State must also plan to expend no more than 10% of its allotment on administrative expenses and prepare an annual report on the use of its allotments. A complete copy of Section 71401’s text is appended hereto as Attachment D.

In preparation for preparing its application, the State is seeking input from relevant stakeholders through a written survey and a forum to be held on August 22, 2025, at the Cobb Center.[footnoteRef:2] A copy of the survey is appended hereto as Attachment E. [2: The Cobb Center is located on the 8th Floor of the Walter Sillers Building, 550 High Street, Jackson, MS 39201.]

Stakeholders who will be invited to respond to the survey and/or participate in the forum include, but are not limited to:

1. The Office of the Governor

2. The Lieutenant Governor

3. The Speaker of the House

4. Chair & Vice Chair, Senate Committee on Drug Policy

5. Chair & Vice Chair, Senate Committee on Medicaid

6. Chair & Vice Chair, Senate Committee on Public Health & Welfare

7. Chair & Vice Chair, House Committee on Drug Policy

8. Chair & Vice Chair, House Committee on Medicaid

9. Chair & Vice Chair, House Committee on Health & Human Services

10. Mississippi State Department of Health

11. Mississippi Division of Medicaid

12. Mississippi Department of Mental Health

13. Mississippi Department of Transportation

14. The Board of Trustees of the Mississippi Institutions of Higher Learning

15. University of Mississippi Medical Center

16. State Intervention Courts Advisory Committee

17. Medicaid Advisory Committee

18. Beneficiary Advisory Committee

19. Emergency Medical Services Advisory Council

20. Mississippi Healthcare Collaborative

21. Mississippi Hospital Association/Rural Hospital Alliance

22. Paladin Emergency Services Consulting

23. Mississippi Rural Health Association

24. Mississippi Association of Community Mental Health Centers

25. Community Health Center Association of Mississippi

26. Rural Emergency Hospital Coalition

27. Mississippi Ambulance Alliance

28. Mississippi healthcare providers or other interested parties

The Office of the Governor, MSDH, and/or DOM will invite up to ten stakeholders to present their ideal plan for rural health transformation at the August 22 forum.

SCOPE OF SERVICES

The successful offeror will be required to work with staff designated by the Governor, the State Health Officer, and the Executive Director of the Division of Medicaid to:

1. Attend the Rural Health Transformation Forum on August 22, 2025 in Jackson, Mississippi.

2. Develop a timeline of tasks to be performed in order to meet the submission deadline. The tasks and deadline may be evolving as new guidance is issued by CMS.

3. Analyze the data gathered through the survey and forum to create a list of possible uses for any funds allotted to the State of Mississippi no later than August 31, 2025. The list should provide enough information regarding each option so that an informed final decision can be made as to which option(s) will be included in the State’s Rural Health Transformation Plan (“the Plan”).

4. Provide weekly written and verbal updates to Office of the Governor, MSDH, and/or DOM staff members on progress toward the goal of submission of the Plan.

5. Prepare the Plan and application in accordance with the requirements established by the Administrator of CMS. The Plan may need to be completed in as little as 30 days but no more than 60 days, depending on the timelines established by CMS.

6. Provide no less than 30 days for review of the Plan and application by the Governor, the State Health Officer, and the Executive Director of the Division of Medicaid, and to make any required revisions.

7. Ensure the Plan and application are timely submitted in accordance with any requirements established by the Administrator of CMS.

TERM

The initial term of the contract shall begin as early as August 4, 2025, and shall expire on December 31, 2025. The contract’s term may be extended for a total contract term of no more than one year. The successful offeror will be expected to execute a contract with terms which are substantially similar to those appended hereto as Attachment F.

HIPAA COMPLIANCE

DOM and MSDH are both covered entities under the Health Insurance Portability and Accountability Act of 1996 (HIPAA). As such, both have legal obligations to protect the privacy of individually identifiable health information in their possession. It is not anticipated that any contract awarded hereunder would involve use of protected health information (PHI). However, by submitting a response to the Request for Quotes, offerors are agreeing to take any necessary steps to ensure both DOM and MSDH remain in compliance with all relevant privacy and security laws and regulations.

SUBMISSION REQUIREMENTS

To be considered for a contract award, interested offerors are required to submit:

1. Attachment A, which has been appropriately completed and executed.

2. A proposal for timely completion of the State’s Rural Health Transformation Plan and Application.

3. A list of staff members who will work on the project, including a summary of their relevant education and experience.

4. A list of similar proposals the offeror has successfully completed for other public or private entities.

5. A pricing structure for the contract.

6. Whether, and to what extent, the offeror is willing to provide the State a rebate on its services should the State not be approved for funding under Section 71401 of the One Big Beautiful Bill Act.

7. Any other information the offeror feels will assist the State in determining to whom, if anyone, a contract should be awarded.

8. A minimum of three references.

All offers shall be submitted to procurement@medicaid.ms.gov no later than 2:00 pm CST on Monday, August 4, 2025. The subject line of the submission email shall read “Consultant: Rural Health Transformation Program.”

Offerors shall not submit any information with its response which the offeror deems to be proprietary or confidential commercial and/or financial information. All submissions shall be available for inspection, in full, by any member of the public. In submitting a quote, offeror is waiving all rights to notice pursuant to Miss. Code Ann. § 25-61-9. Offeror acknowledges and agrees that its submission, in its entirety, may be produced as a public record under the Mississippi Public Records Act, Miss. Code Ann. § 25-61-1, et seq., without further notice.

The State may or may not choose to award contract(s) resulting from this Request for Quotes. Any contract resulting from this Request for Quotes will not require approval from the Public Procurement Review Board.

ATTACHMENT A

Quote Request No. 20250728 Consultant for the State’s Application for the Rural Health Transformation Program

Submission Deadline: August 4, 2025 at 2:00pm CST

Date Quote Submitted: _________________________________________________________________________________________________

Vendor Name: __________________________________________________________________________________________________________

Vendor Official Mailing Address: ______________________________________________________________________________________

Vendor Tax ID Number: ______________________________________________ Age of Business: ______________________________

Authorized Signatory: __________________________________________________________________________________________________

Title: _______________________________________________________ Email: _____________________________________________________

Telephone: ___________________________________________ Alternate Telephone: _________________________________________

Primary Contact Person (if different from Signatory): ______________________________________________________________

Title: _______________________________________________________ Email: _____________________________________________________

Telephone: ___________________________________________ Alternate Telephone: _________________________________________

By submitting a quote, the offeror certifies that the following statements are true and correct. Offeror acknowledges and agrees that compliance with these statements are conditions precedent to contract award and continuation of any contract ultimately awarded.

1. By submitting a quote, the offeror represents that it has not retained any person or agency on a percentage, commission, or other contingent arrangement to secure this contract. If the offeror cannot make such a representation, a full and complete explanation shall be submitted in writing with the offeror’s quote.

2. Offeror represents that it has not, is not, and will not offer, give, or agree to give any employee or former employee of DOM, MSDH, or the Office of the Governor a gratuity or offer of employment in connection with any approval, disapproval, recommendation, development, or any other action or decision related to the solicitation and resulting contract. Offeror further represents that no employee or former employee of DOM, MSDH, or the Office of the Governor has or is soliciting, demanding, accepting, or agreeing to accept a gratuity or offer of employment for the reasons previously stated; any such action by an employee or former employee in the future, if any, will be rejected by offeror. Offeror further represents that it is in compliance with the Mississippi Ethics in Government laws, codified at Mississippi Code Annotated §§ 25-4-101 through 25-4-121, and has not solicited any employee or former employee to act in violation of said law.

3. By submitting a quote, the offeror certifies that the prices submitted in response to the solicitation have been arrived at independently and without any consultation, communication, or agreement with any other offeror or competitor for the purpose of restricting competition.

ATTACHMENT B

DHHS CERTIFICATION REGARDING DRUG-FREE WORKPLACE REQUIREMENTS:

By submitting a quote in response hereto, the offeror is providing the certification set out below.

1) This certification is required by regulations implementing the Drug-Free Act of 1988, 2 CFR Part 382. The regulations require certification by grantees that they will maintain a drug-free workplace. The certification set out below is a material representation of fact upon which reliance will be placed when the DHHS determines to award the grant. If it is later determined that the grantee knowingly rendered a false certification, or otherwise violates the requirements of the Drug-Free Workplace Act, HHS, in addition to any other remedies available to the Federal Government, may take action authorized under the Drug-Free Workplace Act.

2) Workplaces under grants, for grantees other than individuals, need not be identified on the certification. If known, they may be identified in the grant application. If the grantee does not identify the workplaces at the time of application, or upon award, if there is no application, the grantee shall keep the identity of the workplace(s) on file in its office and make the information available for federal inspection. Failure to identify all known workplaces constitutes a violation of the grantee's drug-free workplace requirements.

3) Workplace identifications shall include the actual address of buildings (or parts of buildings) or other sites where work under the grant takes place. Categorical descriptions may be used (e.g., all vehicles of a mass transit authority or State highway department while in operation, State employees in each local unemployment office, performers in concert halls or radio studios).

4) If the workplace identified to DOM changes during the performance of the grant, the grantee shall inform DOM of the change(s), if it previously identified the workplaces in question (see above).

5) Definitions of terms in the Non-procurement Suspension and Debarment common rule and Drug-Free Workplace common rule apply to this certification. Grantees' attention is called, in particular, to the following definitions from these rules:

Definitions

1) "Controlled substance" means a controlled substance in Schedules I through V of the Controlled Substances Act (21 U.S.C. §812) and as further defined by regulation (21 CFR § 1308.11 through § 1308.15);

2) "Conviction" means a finding of guilt (including a plea of nolo contendere) or imposition of sentence, or both, by any judicial body charged with the responsibility to determine violations of the federal or state criminal drug statutes;

3) "Criminal drug statute" means a federal or non-federal criminal statute involving the manufacture, distribution, dispensing, use, or possession of any controlled substance;

4) "Employee" means the employee of a grantee directly engaged in the performance of work under a grant, including (i) all direct charge employees; (ii) all indirect charge employees unless their impact or involvement is insignificant to the performance of the grant; and (iii) temporary personnel and consultants who are directly engaged in the performance of work under the grant and who are on the grantee's payroll. This definition does not include workers not on the payroll of the grantee (e.g., volunteers, even if used to meet a matching requirement; consultants or independent Contractors not on the grantee's payroll; or employees of sub recipients or subcontractors in covered workplaces).

The offeror certifies that it will or will continue to provide a drug-free workplace by:

1) Publishing a statement notifying employees that the unlawful manufacture, distribution, dispensing, possession, or use of a controlled substance is prohibited in the grantee's workplace and specifying the actions that will be taken against employees for violation of such prohibition;

2) Establishing an ongoing drug-free awareness program to inform employees about the dangers of drug abuse in the workplace, the grantee's policy of maintaining a drug-free workplace, any available drug counseling, rehabilitation, and employee assistance programs, and the penalties that may be imposed upon employees for drug abuse violations occurring in the workplace;

3) Making it a requirement that each employee to be engaged in the performance of the grant be given a copy of the statement required by paragraph (1);

4) Notifying the employee in the statement required by paragraph (1) that, as a condition of employment under the grant, the employee will abide by the terms of the statement and notify the employer in writing of his or her conviction for a violation of a criminal drug statute occurring in the workplace no later than five calendar days after such conviction;

5) Notifying DOM in writing, within 10 calendar days after receiving notice under paragraph (4) from an employee or otherwise receiving actual notice of such conviction. Employers of convicted employees must provide notice, including position title, to every grant officer or other designee on whose grant activity the convicted employee was working, unless the federal agency has designated a central point for the receipt of such notices. Notice shall include the identification number(s) of each affected grant;

6) Taking one of the following actions, within 30 calendar days of receiving notice under paragraph (4), with respect to any employee who is so convicted:

a) Taking appropriate personnel action against such an employee, up to and including termination, consistent with requirements of the Rehabilitation Act of 1973, as amended; or

b) Requiring such employee to participate satisfactorily in a drug abuse assistance or rehabilitation program approved for such purposes by a federal, state, or local health, law enforcement, or other appropriate agency;

7) Making a good faith effort to continue to maintain a drug-free workplace through implementation of paragraphs (1) through (6).

8) Complying with all provisions 2 CFR Part 382.

The grantee may insert in the space provided below the physical address(es) for the performance of work done in connection with the specific grant (use attachments if needed):

ATTACHMENT C

DHHS Certification Debarment, Suspension, and Other Responsibility Matters 2 CFR Part 376

By submitting a quote in response hereto, offeror certifies to the best of its knowledge and belief that it and its principals:

1) Are not presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded by any federal department or agency;

2) Have not within a three-year period preceding this bid been convicted of or had a civil judgment rendered against them for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a public (federal, state or local) transaction or contract under a public transaction; violation of federal or state antitrust statutes or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, or receiving stolen property;

3) Are not presently indicted for or otherwise criminally or civilly charged by a government entity (federal, state or local) with commission of any of the offenses enumerated in paragraph (1)(b) of this certification; and,

4) Have not within a three-year period preceding this bid had one or more public transactions (federal, state or local) terminated for cause or default.

ATTACHMENT D

HR 1 of the 119th Congress Title VII, Subtitle B, Chapter 4, Section 71401 Rural Health Transformation Program

(a) In General.--Section 2105 of the Social Security Act (42 U.S.C. 1397ee) is amended by adding at the end the following new subsection:

``(h) Rural Health Transformation Program.— ``(1) Appropriation.— ``(A) In general.--There are appropriated, out of any money in the Treasury not otherwise appropriated, to the Administrator of the Centers for Medicare & Medicaid Services (in this subsection referred to as the `Administrator'), to provide allotments to States for purposes of carrying out the activities described in paragraph (6)-- ``(i) $10,000,000,000 for fiscal year 2026;

``(ii) $10,000,000,000 for fiscal year 2027;

``(iii) $10,000,000,000 for fiscal year 2028;

``(iv) $10,000,000,000 for fiscal year 2029; and ``(v) $10,000,000,000 for fiscal year 2030.

``(B) Unexpended or unobligated funds.-- ``(i) In general.--Any amounts appropriated under subparagraph (A) that are unexpended or unobligated as of October 1, 2032, shall be returned to the Treasury of the United States.

``(ii) Redistribution of unexpended or unobligated funds.--In carrying out subparagraph (A), the Administrator shall, not later than March 31, 2028, and annually thereafter through March 31, 2032, determine the amount of funds, if any, that are available under such subparagraph for a previous fiscal year, are unexpended or unobligated with respect to such fiscal year, and will not be available to a State in the current fiscal year, pursuant to clause (iii).

``(iii) Availability of funds.— `(I) In general.--Amounts allotted to a State under this subsection for a year shall be available for expenditure by the State through the end of the fiscal year following the fiscal year in which such amounts are allotted.

``(II) Availability of amounts redistributed.--Amounts redistributed to a State under clause (ii) with respect to a fiscal year shall be available for expenditure by the State through the end of the fiscal year following the fiscal year in which such amounts are redistributed (except in the case of amounts redistributed in fiscal year 2032 which shall only be available for expenditure through September 30, 2032).

``(iv) Misuse of funds.--If the Administrator determines that a State is not using amounts allotted or redistributed to the State under this subsection in a manner consistent with the description provided by the State in its application approved under paragraph (2), the Administrator may withhold payments to, or reduce payments to, or recover previous payments from, the State under this subsection as the Administrator deems appropriate, and any amounts so withheld, or that remain after any such reduction, or so recovered, shall be returned to the Treasury of the United States.

``(2) Application.-- ``(A) In general.--To be eligible for an allotment under this subsection, a State shall submit to the Administrator during an application submission period to be specified by the Administrator (but that ends not later than December 31, 2025) an application in such form and manner as the Administrator may specify, that includes— ``(i) a detailed rural health transformation plan-- ``(I) to improve access to hospitals, other health care providers, and health care items and services furnished to rural residents of the State;

``(II) to improve health care outcomes of rural residents of the State;

``(III) to prioritize the use of new and emerging technologies that emphasize prevention and chronic disease management;

``(IV) to initiate, foster, and strengthen local and regional strategic partnerships between rural hospitals and other health care providers in order to promote measurable quality improvement, increase financial stability, maximize economies of scale, and share best practices in care delivery;

``(V) to enhance economic opportunity for, and the supply of, health care clinicians through enhanced recruitment and training;

``(VI) to prioritize data and technology driven solutions that help rural hospitals and other rural health care providers furnish high-quality health care services as close to a patient's home as is possible;

``(VII) that outlines strategies to manage long-term financial solvency and operating models of rural hospitals in the State; and ``(VIII) that identifies specific causes driving the accelerating rate of stand-alone rural hospitals becoming at risk of closure, conversion, or service reduction;

``(ii) a certification that none of the amounts provided under this subsection shall be used by the State for an expenditure that is attributable to an intergovernmental transfer, certified public expenditure, or any other expenditure to finance the non-Federal share of expenditures required under any provision of law, including under the State plan established under this title, the State plan established under title XIX, or under a waiver of such plans; and ``(iii) such other information as the Administrator may require.

``(B) Deadline for approval.--Not later than December 31, 2025, the Administrator shall approve or deny all applications submitted for an allotment under this subsection.

``(C) One-time application.--If an application of a State for an allotment under this subsection is approved by the Administrator, the State shall be eligible for an allotment under this subsection for each of fiscal years 2026 through 2030, except as provided in paragraph (1)(B)(iv).

``(D) Eligibility.--Only the 50 States shall be eligible for an allotment under this subsection and all references in this subsection to a State shall be treated as only referring to the 50 States.

``(3) Allotments.-- ``(A) In general.--For each of fiscal years 2026 through 2030, the Administrator shall determine under subparagraph (B) the amount of the allotment for such fiscal year for each State with an approved application under this subsection.

``(B) Amount determined.--Subject to subparagraph (C), from the amounts appropriated under paragraph (1)(A) for each of fiscal years 2026 through 2030, the Administrator shall allot— ``(i) 50 percent of the amounts appropriated for each such fiscal year equally among all States with an approved application under this subsection; and ``(ii) 50 percent of the amounts appropriated for each such fiscal year among all such States in an amount to be determined by the Administrator in accordance with subparagraph (C).

``(C) Requirements.--In determining the amount to be allotted to a State under clause (ii) of subparagraph (B) for a fiscal year, the Administrator shall-- ``(i) ensure that not less than \1/4\ of the States with an approved application under this subsection for a fiscal year are allotted funds from amounts that are to be allotted under clause (ii) of such subparagraph; and ``(ii) consider— ``(I) the percentage of the State population that is located in a rural census tract of a metropolitan statistical area (as determined under the most recent modification of the Goldsmith Modification, originally published in the Federal Register on February 27, 1992 (57 Fed. Reg. 6725));

``(II) the proportion of rural health facilities (as defined in subparagraph (D)) in the State relative to the number of rural health facilities nationwide;

``(III) the situation of hospitals in the State, as described in section 1902(a)(13)(A)(iv); and ``(IV) any other factors that the Administrator determines appropriate.

``(D) Rural health facility defined.--For the purposes of subparagraph (C)(ii), the term `rural health facility' means the following:

``(i) A subsection (d) hospital (as defined in paragraph (1)(B) of section 1886(d)) that-- ``(I) is located in a rural area (as defined in paragraph (2)(D) of such section);

``(II) is treated as being located in a rural area pursuant to paragraph (8)(E) of such section; or ``(III) is located in a rural census tract of a metropolitan statistical area (as determined under the most recent modification of the Goldsmith Modification, originally published in the Federal Register on February 27, 1992 (57 Fed. Reg. 6725)).

``(ii) A critical access hospital (as defined in section 1861(mm)(1)).

``(iii) A sole community hospital (as defined in section 1886(d)(5)(D)(iii)).

``(iv) A Medicare-dependent, small rural hospital (as defined in section 1886(d)(5)(G)(iv)).

``(v) A low-volume hospital (as defined in section 1886(d)(12)(C)).

``(vi) A rural emergency hospital (as defined in section 1861(kkk)(2)).

``(vii) A rural health clinic (as defined in section 1861(aa)(2)).

``(viii) A Federally qualified health center (as defined in section 1861(aa)(4)).

``(ix) A community mental health center (as defined in section 1861(ff)(3)(B)).

``(x) A health center that is receiving a grant under section 330 of the Public Health Service Act.

``(xi) An opioid treatment program (as defined in section 1861(jjj)(2)) that is located in a rural census tract of a metropolitan statistical area (as determined under the most recent modification of the Goldsmith Modification, originally published in the Federal Register on February 27, 1992 (57 Fed. Reg. 6725)).

``(xii) A certified community behavioral health clinic (as defined in section 1905(jj)(2)) that is located in a rural census tract of a metropolitan statistical area (as determined under the most recent modification of the Goldsmith Modification, originally published in the Federal Register on February 27, 1992 (57 Fed. Reg. 6725)).

``(4) No matching payment.--A State approved for an allotment under this subsection for a fiscal year shall not be required to provide any matching funds as a condition for receiving payments from the allotment.

``(5) Terms and conditions.--The Administrator shall specify such terms and conditions for allotments to States provided under this subsection as the Administrator deems appropriate, including the following:

``(A) Each State shall submit to the Administrator (at a time, and in a form and manner, specified by the Administrator)-- ``(i) a plan for the State to use its allotment to carry out 3 or more of the activities described in paragraph (6); and ``(ii) annual reports on the use of allotments, including such additional information as the Administrator determines appropriate.

``(B) Not more than 10 percent of the amount allotted to a State for a fiscal year may be used by the State for administrative expenses.

``(6) Use of funds.--Amounts allotted to a State under this subsection shall be used for 3 or more of the following health-related activities:

``(A) Promoting evidence-based, measurable interventions to improve prevention and chronic disease management.

``(B) Providing payments to health care providers for the provision of health care items or services, as specified by the Administrator.

``(C) Promoting consumer-facing, technology-driven solutions for the prevention and management of chronic diseases.

``(D) Providing training and technical assistance for the development and adoption of technology-enabled solutions that improve care delivery in rural hospitals, including remote monitoring, robotics, artificial intelligence, and other advanced technologies.

``(E) Recruiting and retaining clinical workforce talent to rural areas, with commitments to serve rural communities for a minimum of 5 years.

``(F) Providing technical assistance, software, and hardware for significant information technology advances designed to improve efficiency, enhance cybersecurity capability development, and improve patient health outcomes.

``(G) Assisting rural communities to right size their health care delivery systems by identifying needed preventative, ambulatory, pre-hospital, emergency, acute inpatient care, outpatient care, and post-acute care service lines.

``(H) Supporting access to opioid use disorder treatment services (as defined in section 1861(jjj)(1)), other substance use disorder treatment services, and mental health services.

``(I) Developing projects that support innovative models of care that include value-based care arrangements and alternative payment models, as appropriate.

``(J) Additional uses designed to promote sustainable access to high quality rural health care services, as determined by the Administrator.

``(7) Exemptions.--Paragraphs (2), (3), (5), (6), (8), (10), (11), and (12) of subsection (c) do not apply to payments under this subsection.

``(8) Review.--There shall be no administrative or judicial review under section 1116 or otherwise of amounts allotted or redistributed to States under this subsection, payments to States withheld or reduced under this subsection, or previous payments recovered from States under this subsection.

``(9) Health care provider defined.--For purposes of this subsection, the term `health care provider' means a provider of services or supplier who is enrolled under this title, title XVIII, or title XIX.''.

(b) Conforming Amendments.--Title XXI of the Social Security Act 42 U.S.C. 1397aa) is amended--

(1) in section 2101--

(A) in subsection (a), in the matter preceding paragraph (1), by striking ``The purpose'' and inserting ``Except with respect to the rural health transformation program established in section 2105(h), the purpose''; and

(B) in subsection (b), in the matter preceding paragraph (1), by inserting ``subsection (a) or (g) of'' before ``section 2105'';

(2) in section 2105(c)(1), by striking ``and may not include'' and inserting ``or to carry out the rural health transformation program established in subsection (h) and, except in the case of amounts made available under subsection (h), may not include''; and

(3) in section 2106(a)(1), by inserting ``subsection (a) or (g) of'' before ``section 2105''.

(c) Implementation.--The Administrator of the Centers for Medicare Medicaid Services shall implement this section, including the amendments made by this section, by program instruction or other forms of program guidance.

(d) Implementation Funding.--For the purposes of carrying out the provisions of, and the amendments made by, this section, there are appropriated, out of any monies in the Treasury not otherwise appropriated, to the Administrator of the Centers for Medicare & Medicaid Services, $200,000,000 for fiscal year 2025, to remain available until expended.

ATTACHMENT E

Survey

Rural Health Transformation Program Stakeholder Survey is only available via PDF, located on DOM’s website. Procurement - Mississippi Division of Medicaid

ATTACHMENT F

DRAFT CONTRACTUAL AGREEMENT BETWEEN

THE DIVISION OF MEDICAID IN THE OFFICE OF THE GOVERNOR

AND CONSULTANT

(Rural Health Transformation Program)

THIS AGREEMENT is made and entered into by and between the DIVISION OF MEDICAID IN THE OFFICE OF THE GOVERNOR, an administrative agency of the STATE OF MISSISSIPPI, hereinafter referred to as “DOM,” and CONSULTANT, hereinafter referred to as “Contractor,” for the performance of professional services.

WHEREAS, pursuant to House Resolution 1 of the 119th Congress, the One Big Beautiful Bill Act (OBBBA), the Administrator of the Centers for Medicare & Medicaid Services (CMS) shall accept applications from States for a Rural Health Transformation Program;

WHEREAS, if such application is approved on or before December 31, 2025, Mississippi shall receive no less than $100,000,000.00 annually to implement its rural health transformation plan;

WHEREAS, OBBBA was signed into law on July 4, 2025;

WHEREAS, the Office of the Governor has requested that DOM and the Mississippi State Department of Health (MSDH) collaborate to create the State’s plan and prepare the State’s application;

WHEREAS, due to the compressed timeline to secure the available federal funding, the State has retained a consultant to assist with preparation of the State’s application for the Rural Health Transformation Program on an emergency basis;

NOW THEREFORE, in consideration of the mutual covenants contained herein and subject to the terms and conditions hereinafter stated, it is hereby understood and agreed by the Parties hereto as follows:

I. PERIOD OF PERFORMANCE: The term of this Agreement shall commence on August 4, 2025, and shall expire on December 31, 2025, unless this Agreement is terminated pursuant to the Termination provisions herein. This Agreement may be extended for a total contract period not to exceed one year if mutually agreed upon in writing by both parties prior to the end of the current term.

II. SCOPE OF WORK: As further described in Attachment A (DOM’s Request for Quotes) and Attachment B (Contractor’s Quote), which are fully incorporated herein, Contractor agrees to work with the Office of the Governor, DOM, and MSDH to prepare the State’s application for the Rural Health Transformation Program. To the extent of a conflict among the various contract documents, this Contract shall have priority over Attachments A and B, and Attachment A shall have priority over Attachment B.

III. COORDINATION OF SERVICES: Contractor shall coordinate the performance of the services to be provided hereunder with and through DOM’s Office of Executive Services and consult with said Office on specific courses of action that should be pursued.

IV. COST FOR SERVICES: As full and complete compensation for the services to be provided hereunder, DOM will pay Contractor at the amounts and rates listed below:

Describe pricing structure submitted by successful offeror.

V. REBATE

Describe the rebate submitted by the successful offeror.

VI. BILLING AND DOCUMENTATION OF TIME: Billing at the cost specified in Article IV (Cost of Services) above will be made by Contractor on a form prescribed by DOM for such purposes.

Describe billing process (to be established by DOM).

VII. APPLICABLE LAW: The contract shall be governed by and construed in accordance with the laws of the State of Mississippi, excluding its conflicts of laws provisions, and any litigation with respect thereto shall be brought in the courts of Mississippi.

VIII. AVAILABILITY OF FUNDS: It is expressly understood and agreed that the obligation of DOM to proceed under this agreement is conditioned upon the appropriation of funds by the Mississippi State Legislature and the receipt the appropriated funds. If the funds anticipated for the continuing time fulfillment of the agreement are, at any time, not forthcoming or insufficient, regardless of the source of funding, DOM shall have the right upon 10 business days written notice to Contractor, to terminate this agreement without damage, penalty, cost or expense to the DOM of any kind whatsoever. The effective date of termination shall be as specified in the notice of termination.

IX. COMPLIANCE WITH EQUAL OPPORTUNITY IN EMPLOYMENT POLICY: Contractor understands that the DOM is an equal opportunity employer and therefore, maintains a policy which prohibits unlawful discrimination based on race, color, creed, sex, age, national origin, physical handicap, disability, genetic information, or any other consideration made unlawful by federal, state, or local laws. All such discrimination is unlawful, and Contractor agrees during the term of the agreement that Contractor will strictly adhere to this policy in its employment practices and provision of services.

X. COMPLIANCE WITH LAWS: Contractor shall comply with, and all activities under this agreement shall be subject to, all applicable federal, state, and local laws and regulations, as now existing and as may be amended or modified.

XI. E-PAYMENT: Contractor agrees to accept all payments in United States currency via the State of Mississippi’s electronic payment and remittance vehicle. The Agency agrees to make payment in accordance with Mississippi “Timely Payments for Purchases by Public Bodies” laws, which generally provide for payment of undisputed amounts by the Agency within 45 calendar days of receipt of invoice. Mississippi Code Annotated § 31-7-301, et seq.

XII. E-VERIFICATION: If applicable, Contractor represents and warrants that it will ensure its compliance with the Mississippi Employment Protection Act and will register and participate in the status verification system for all newly hired employees. Mississippi Code Annotated §§ 71-11-1 and 71-11-3. Contractor agrees to provide a copy of each verification upon request of the DOM subject to approval by any agencies of the United States Government. Contractor further represents and warrants that any person assigned to perform services hereafter meets the employment eligibility requirements of all immigration laws.

The breach of this clause may subject Contractor to the following: (1) termination of this contract and exclusion pursuant to Chapter 15 of the Public Procurement Review Board Office of Personal Service Contract Review Rules and Regulations; (2) the loss of any license, permit, certification or other document granted to Contractor by an agency, department, or governmental entity for the right to do business in Mississippi; or (3) both. In the event of such termination, Contractor would also be liable for any additional costs incurred by the Agency due to Contract cancellation or loss of license or permit to do business in the state.

XIII. NO LIMITATION OF LIABILITY: Nothing in this agreement shall be interpreted as excluding or limiting any liability of the Contractor for harm arising out of the Contractor’s or its subcontractors’ performance under this agreement.

XIV. PAYMODE: Payments by DOM using the state’s accounting system shall be made and remittance information provided electronically as directed by the state and deposited into the bank account of Contractor’s choice. The DOM may, at its sole discretion, require Contractor to electronically submit invoices and supporting documentation at any time during the term of this Agreement. Contractor understands and agrees that the Agency is exempt from the payment of Mississippi taxes. All payments shall be in United States currency.

XV. PROCUREMENT REGULATIONS: This contract shall be governed by the applicable provisions of the Public Procurement Review Board Office of Personal Service Contract Review Rules and Regulations, a copy of which is available on the Mississippi Department of Finance and Administration’s website (www.dfa.ms.gov). Any offeror responding to a solicitation for personal and professional services and any contractor doing business with a state Agency is deemed to be on notice of all requirements therein.

XVI. PROPERTY RIGHTS: Property rights do not inure to Contractor until such time as services have been provided under a legally executed contract. Contractor has no legitimate claim of entitlement to the provision of work hereunder and acknowledges that the DOM may terminate this contract at any time for its own convenience.

XVII. REQUIRED PUBLIC RECORDS AND TRANSPARENCY: Contractor agrees nothing in this contract or the proposal/quote submitted in response to DOM’s Request for Quotes contains confidential commercial and financial information or material otherwise proprietary and exempt from disclosure under the Mississippi Public Records Act. Contractor affirmatively waives any right to notice before any part of this contract is produced to a third party. The contract shall be posted publicly on www.transparency.ms.gov and shall be available for at the Agency for examination, inspection, or reproduction by the public. The contractor acknowledges and agrees that the DOM and this contract are subject to the Mississippi Public Records Act of 1983 codified at Mississippi Code Annotated §§ 25-61-1, et seq. and its exceptions, Mississippi Code Annotated § 79-23-1, and the Mississippi Accountability and Transparency Act of 2008, codified at Mississippi Code Annotated §§ 27-104-151, et seq.

XVIII. CONTRACTOR’S REPRESENTATION REGARDING CONTINGENT FEES: By executing this contract, the Contractor represents that it has not retained any person or agency on a percentage, commission, or other contingent arrangement to secure this contract. If the contractor cannot make such a representation, a full and complete explanation shall be submitted in writing to the Agency prior to contract execution.

XIX. REPRESENTATION REGARDING GRATUITIES: Contractor represents that it has not, is not, and will not offer, give, or agree to give any employee or former employee of DOM a gratuity or offer of employment in connection with any approval, disapproval, recommendation, development, or any other action or decision related to the solicitation and resulting contract. Contractor further represents that no employee or former employee of DOM has or is soliciting, demanding, accepting, or agreeing to accept a gratuity or offer of employment for the reasons previously stated; any such action by an employee or former employee in the future, if any, will be rejected by contractor. Contractor further represents that it is in compliance with the Mississippi Ethics in Government laws, codified at Mississippi Code Annotated §§ 25-4-101 through 25-4-121, and has not solicited any employee or former employee to act in violation of said law.

XX. STOP WORK ORDER: The DOM may, by written order to Contractor at any time, require Contractor to stop all or any part of the work called for by this contract. This order shall be for a period of time specified by the DOM. Upon receipt of such an order, Contractor shall forthwith comply with its terms and take all reasonable steps to minimize any further cost to the DOM. Upon expiration of the stop work order, Contractor shall resume providing the services which were subject to the stop work order, unless the DOM has terminated that part of the agreement or terminated the agreement in its entirety. The DOM is not liable for payment for services which were not rendered due to the stop work order.

XXI. TERMINATION:

Termination for Convenience. The DOM may, when the interests of the Agency so require, terminate this contract in whole or in part, for the convenience of the Agency. The DOM shall give written notice of the termination to Contractor specifying the part of the contract terminated and when termination becomes effective. Contractor shall incur no further obligations in connection with the terminated work and on the date set in the notice of termination Contractor will stop work to the extent specified. Contractor shall complete the work not terminated by the notice of termination and may incur obligations as are necessary to do so.

Termination for Default. If the DOM gives the Contractor a notice that the personal or professional services are being provided in a manner that is deficient, the Contractor shall have 30 days to cure the deficiency. If the Contractor fails to cure the deficiency, the DOM may terminate the contract for default and the Contractor will be liable for the additional cost to the DOM to procure the personal and professional services from another source. Termination under this paragraph could result in Contractor being excluded from future contract awards pursuant to Chapter 15 of the Public Procurement Review Board Office of Personal Service Contract Review Rules and Regulations. Any termination wrongly labelled termination for default shall be deemed a termination for convenience.

XXII. INDEPENDENT CONTRACTOR STATUS: Contractor shall, at all times, be regarded as and shall be legally considered an independent contractor and shall at no time act as an agent for DOM. Nothing contained herein shall be deemed or construed by DOM, Contractor, or any third party as creating the relationship of principal and agent, master and servant, partners, joint ventures, employer and employee, or any similar such relationship between DOM and Contractor. Neither the method of computation of fees or other charges, nor any other provision contained herein, nor any acts of DOM or Contractor hereunder creates, or shall be deemed to create a relationship other than the independent relationship of DOM and Contractor.

Contractor’s personnel shall not be deemed in any way, directly or indirectly, expressly or by implication, to be employees of DOM. Neither Contractor nor its employees shall, under any circumstances, be considered servants, agents, or employees of DOM, and DOM shall be at no time legally responsible for any negligence or other wrongdoing by Contractor, its servants, agents, or employees.

DOM shall not withhold from the contract payments to Contractor any federal or state income taxes, Social Security tax, or any other amounts for benefits to Contractor.