REQ-DASOBO-00059475(1113-19)_AMD2_approved~1.pdf

SP No. REQ-DASOBO-00059475 (1113-19)_AMD2_OSPHL Billing Services Page 1 of 5

REQUEST FOR SPECIAL PROCUREMENT No. REQ-DASOBO-00059475 (formerly SP-1113-19), Amendment No. 2

PART A. Requesting Agency must complete Items 1 through 13.

1. Requesting Agency Name: The Department of Administrative Services, Procurement Services (DAS PS) on behalf of the Oregon Health Authority (OHA), Public Health Division (PHD), Oregon State Public Health Laboratory (OSPHL)

2. Date of Request: June 10, 2024 3. Agency Number: 107090

4. Agency Contact Name: Ashley Wenger 5. Phone: (971) 719-0322

6. Type of Request: ___ Class Special Procurement _X_ Contract-specific Special Procurement

7. Amendment Time Period Requested: From: August 1, 2024 To: July 31, 2026

8. Total Estimated Cost for Amendment Time Period: $390,000

9. Title: Supplies and/or Services to be acquired: Billing Services for OSPHL

10. Amendment Request, Background, Current Need, and Proposed Contracting Procedure:

a. Amendment Request: DAS PS, on behalf of the OHA/PHD/OSPHL, requests approval of this Special Procurement (SP), No. REQ-DASOBO-00059475 (formerly SP-1113-19), Amendment No. 2 (SP Amd-2) to extend Contract No. PO-DASOBO-00009771, [formerly DASPS-3166-19 (OHA-145893-14)] (Contract) with Public Consulting Group, Inc. (PCG) for an additional two (2) years and to increase the current not-to-exceed (NTE) of $1,350,000 by $390,000 for a maximum NTE of $1,740,000.

b. Background: Under the Contract, PCG is the services provider that submits claims to third party payers and receives electronic and paper remit data. OSPHL receives specimens from hundreds of submitters, and billing rules are determined by the type of testing and numerous other circumstances.

PCG monitors these rules, analyzes the testing data that OSPHL provides, and prepares claims accordingly. Also included in PCG’s services under this contract is the management of the payer enrollment process for OHA to receive Electronic Fund Transfers (EFT) for direct deposit of reimbursements to OHA. PCG has streamlined this process by configuring its internal billing systems to work with OHA data.

Procurement History:

• Starting with the issuance of OHA’s Request for Proposals (RFP) #3699 on January 13, 2014, it led to the execution of the original Contract #145893-14 on August 15, 2014, with a maximum term period of up to five (5) years.

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• SP-1113-19 was approved on April 18, 2019 in order to extend the Contract for an additional year with the intent to provide time for issuing a competitive solicitation. The SP was posted for seven (7) days on the Oregon Procurement Information Network (ORPIN) on April 29, 2019. No protests were received and Amendment No. 1 to the Contract was executed.

• SP-1113-19 was further amended on April 8, 2020, to add four (4) additional years to the contract, as it was determined that the original one (1) year contract extension was not sufficient to develop the competitive solicitation, as more requirements were discovered through market research. The additional four (4) years would have been sufficient time to prepare an RFP, review proposals, and implement a new contract, but the national COVID-19 Public Health Emergency (PHE) that was declared on January 31, 2020, lasted much longer than initially anticipated and only ended on May 11, 2023.

• A solicitation process is underway, but it is unlikely that it will be completed before the Contract expires. OHA is currently working with the Department of Justice (DOJ), Cyber security Services (CSS) and Enterprise Information Services (EIS) to build the RFP and sample contract language. While involving these partners represents a significant move forward, OHA is only partway through the full RFP process, which could still take up to two (2) years for full implementation of a possible new solution.

For further historical context and background information on the Special Procurement SP-1113-19, please refer to SP_Attachment 1, which contains the original and subsequent amendment.

c. Current Need: The PHE and COVID-19 pandemic significantly impacted the workload of OSPHL, stretching capacity to the limits as laboratory employees implemented new testing systems for the new virus and responded to the severely increased demand for testing throughout Oregon. Due to the emergency of COVID-19, OSPHL has not been able to devote the time and resources needed to develop a new, formal solicitation process for billing services.

The breakdown of service costs as documented in the Special Procurement Request are as follows:

Date Executed Special Procurement Request Increase / Not To Exceed (NTE) 04/29/2019 SP-1113-19, Original $0 / $810,000 04/28/2020 SP-1113-19, Amendment 1 $540,000 / $1,350,000 Pending SP-1113-19, Amendment 2 $390,000 / $1,740,000

d. Proposed Contracting Procedure:

• DAS PS, on behalf of OHA, will issue a public notice on OregonBuys for a period of seven (7) calendar days, as required by Administrative Rule (OAR 125-247-0287), regarding approval of this SP Amd-2.

• Advertisement of the SP Amd-2 will include provisions that any affected person may protest the approval of the SP Amd-2.

• If no protests to this SP Amd-2 are received or sustained, DAS PS, on behalf of OHA, will enter into negotiation with PCG to amend and extend Contract No. PO-DASOBO-00009771 (formerly

DASPS-3166-19 (OHA-145893-14).

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• DAS PS will retain contracting authority of the Contract through the term of this SP Amd-2, if approved.

• DAS PS and OHA will work with EIS and obtain its endorsement prior to executing the Contract Amendment, if required.

• DAS PS will obtain DOJ legal sufficiency approval before executing the Contract Amendment in accordance with ORS 291.047.

• OHA will continue development of a comprehensive formal competitive solicitation for the needed services during the term of this SP Amd-2.

11. Justification for use of Special Procurement: Describe the circumstances that justify the use of a Special Procurement. Attach relevant documentation.

OHA issued a Formal RFP (OHA-3699-14) for Billing Services for the OSPHL, which was a publicly noticed competitive process that resulted in the award of the Contract and further extended by State CPO’s original approval of SP-1113-19. Only two (2) proposers responded to the original RFP and no one protested SP-1113-19. This service continues to be mission critical and OHA cannot have a lapse in this contract or services while waiting for the competitive solicitation process to be completed.

The current contract with PCG:

• provides for consistent, accurate, and uninterrupted service delivery, ensuring maximum return on OHA’s considerable investment in OSHPL’s critical operational and business processes, and

• represents a best value and best practice course of action for OHA in supporting the time to construct a more well-informed, well-considered and timely procurement activity for continuing these services following Contract expiration, while keeping with State and OHA Information Technology (IT) investment strategies.

The same findings and supporting facts provided in the Original SP and subsequent SP Amd-1

(SP_Attachment-1) still apply.

12. Findings to Satisfy the Required Standards: This proposed special procurement:

__X___ (a) will be unlikely to encourage favoritism in the awarding of public contracts or to substantially diminish competition for public contracts because:

Over the course of the 2-year term in this SP Amd-2 Request, OHA intends to continue development of a formal, competitive procurement for replacement services. As stated in Section 10.b, the RFP development is well underway by OHA and the anticipated release date is approximately in the next six

(6) months.

The procurement activity anticipated at the end of the extended contract period will comply with the Oregon Procurement Code, ORS 279A and ORS 279B. Approval of the SP Amd-2 request would afford OHA sufficient time to develop a comprehensive RFP which, upon approval to release, would foster competition among potential service providers.

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______ (b)(i) will result in substantial cost savings to the contracting agency or to the public because:

or

_X__ (b)(ii) will otherwise substantially promote the public interest in a manner that could not practicably be realized by complying with the requirements of ORS 279B.055, 279B.060, 279B.065, or 279B.070, or any rules adopted thereunder because:

OSPHL performs testing for local public health authorities and other submitters serving high-risk or disadvantaged populations. This includes testing for sexually transmitted infections including chlamydia, gonorrhea, syphilis, and HIV. This testing is largely underfunded, and the revenue generated from fees is placed into an account that is used for personnel and supplies that are needed to perform this work and other public health testing. If OSPHL was unable to bill or collect these fees, the testing would be drastically reduced or discontinued, which could lead to a significant public health risk.

If this Contract ends without a replacement, OSPHL faces a substantial revenue loss. Without a new Contract in place upon the expiration of the current Public Consulting Group Contract, OSPHL's revenue streams would suffer adverse effects across various operations. The organization lacks the capacity and expertise to manually process billing and claims, leading to a significant impact on payment efficiency and potential loss of thousands of dollars due to reimbursement timeline constraints. OSPHL currently generates $850,000 in annual claims, receiving approximately $650,000 of those funds. Additionally, the Office of Financial Services (OFS) within the agency cannot bill Medicaid for laboratory tests performed at OSPHL due to internal control standards, as OHA cannot simultaneously bill and pay.

The performance of the Contract provides critical billing services for OSPHL and ultimately, the citizens of Oregon. Loss of the services through this Contract would require OSPHL to hire a workforce to handle billing, as one does not currently exist, and force a transition to a paper billing process, causing enormous delays in billing processing and payments in addition to creating unbudgeted expenses.

The same findings and supporting facts provided in the Original SP and subsequent SP Amd-1 (SP_Attachment-1) still apply.

13. Signature: The actual signature of the Agency Head or designee (e.g., Designated Procurement Officer) is not required on the Request submitted through OregonBuys. Agency may elect to attach a signed Request as a pdf file through OregonBuys or submit a signed hard copy Request.

Signature: e.g. Electronically in OregonBuys _________________ Name/Title: Date:

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PART B. The Department of Administrative Services completes Part B.

STATUTORY AND RULE AUTHORITY:

ORS 279B.085(2) states the Director of the Department of Administrative Services may approve a special procurement if the Director finds that a written request submitted under ORS 279B.085(4) demonstrates that the use of a special procurement as described in the request, or an alternative procedure prescribed by the Director will:

(a) Be unlikely to encourage favoritism in the awarding of public contracts or to substantially diminish competition for public contracts; and (b)(A) Result in substantial cost savings to the contracting agency or to the public; or

(B) Otherwise substantially promote the public interest in a manner that could not practicably be realized by complying with requirements that are applicable under ORS 279B.055, 279B.060, 279B.065 or 279B.070 or under any rules adopted thereunder.

OAR 125-246-0170 delegates the authority of the Director of the Department of Administrative Services to approve special procurements to the State Chief Procurement Officer. OAR 125-247-0285 through 125-247- 0288 implement ORS 279B.085.

OAR 125-247-0700(2) Protests and Judicial Review of Special Procurements designates the State Chief Procurement Officer as the Contract Review Authority.

FINDINGS: The findings are accepted, adopted, and incorporated by reference herein.

CONDITIONS OF APPROVAL:

1. Notice Period. The Authorized Agency shall post the Public Notice on OregonBuys. The Special

Procurement may not be used until after the completion of the seven (7) day notice period required pursuant to OAR 125-247-0287(4), and either:

a. No Written protests are received by the Contract Review Authority, State Chief Procurement Officer, from an Affected Person in response to the notice, or

b. If any protest is received during the notice period, then not until:

i. the State Chief Procurement Officer or delegate issues a written disposition of the protest in accordance with ORS 279B.400 and OAR 125-247-0700 and OAR 137-047-0700, and

ii. confirms in writing the first possible date of use of the Special Procurement.

2. ORS 279A.165 Requirements. Authorized Agency shall comply with the requirements of ORS 279A.165 and OAR 125-247-0287(12) regarding a report about this Special Procurement. Agency shall use a form and follow the instructions provided by the State Chief Procurement Officer or delegate.

3. Enterprise Information Services Compliance. Authorized Agency shall comply with all Enterprise Information Services (“EIS”) conditions and requirements prior to contract execution, if any.

APPROVED:

Jay Jackson, Procurement Policy Officer Date:

Department of Administrative Services, Procurement Services

07/12/2024