RFP 2026-0200-0067 02-101-26 Fast Track Medicaid Mediation Program.pdf

STATE OF ALASKA

REQUEST FOR PROPOSALS

OFFERORS ARE NOT REQUIRED TO RETURN THIS FORM.

IMPORTANT NOTICE: IF YOU RECEIVED THIS SOLICITATION FROM THE STATE OF ALASKA’S “ONLINE PUBLIC

NOTICE” WEB SITE, YOU MUST REGISTER WITH THE PROCUREMENT OFFICER LISTED IN THIS DOCUMENT TO

RECEIVE NOTIFICATION OF SUBSEQUENT AMENDMENTS. FAILURE TO CONTACT THE PROCUREMENT OFFICER MAY

RESULT IN THE REJECTION OF YOUR OFFER.

ISSUED BY:

DEPARTMENT OF ADMINISTRATION

OFFICE OF ADMINISTRATIVE HEARINGS

PRIMARY CONTACT:

CHRISTINE MASH

PROCUREMENT OFFICER

DOA.OPPM.PROCUREMENT@ALASKA.GOV

OAH FAST TRACK MEDICAID MEDIATION PROGRAM

RFP 2026-0200-0067 02-101-26

ISSUED SEPTEMBER 23, 2025

THE PURPOSE OF THIS RFP IS TO SECURE A STRUCTURED, COST-EFFECTIVE DISPUTE RESOLUTION PROCESS FOR

APPEALS OF DETERMINATIONS OF THE DEPARTMENT OF HEALTH, SENIOR AND DISABILITIES SERVICES DIVISION

AND HEALTH CARE SERVICES DIVISION, REGARDING MEDICAID COVERAGE FOR REQUESTED SERVICES.

STATE OF ALASKA – REQUEST FOR PROPOSALS RFP 2026-0200-0067 02-101-26

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TABLE OF CONTENTS

INTRODUCTION & INSTRUCTIONS

SEC. 1.01 PURPOSE OF THE RFP

SEC. 1.02 BUDGET

SEC. 1.03 DEADLINE FOR RECEIPT OF PROPOSALS

SEC. 1.04 PRIOR EXPERIENCE

SEC. 1.05 REQUIRED REVIEW

SEC. 1.06 QUESTIONS PRIOR TO DEADLINE FOR RECEIPT OF PROPOSALS

SEC. 1.07 RETURN INSTRUCTIONS

SEC. 1.08 ASSISTANCE TO OFFERORS WITH A DISABILITY

SEC. 1.09 AMENDMENTS TO PROPOSALS

SEC. 1.10 AMENDMENTS TO THE RFP

SEC. 1.11 RFP SCHEDULE

SEC. 1.12 ALTERNATE PROPOSALS

SEC. 1.13 NEWS RELEASES

SECTION 2. BACKGROUND INFORMATION

SEC. 2.01 BACKGROUND INFORMATION

SECTION 3. SCOPE OF WORK & CONTRACT INFORMATION

SEC. 3.01 SCOPE OF WORK

SEC. 3.02 CONTRACT TERM AND WORK SCHEDULE

SEC. 3.03 DELIVERABLES

SEC. 3.04 CONTRACT TYPE

SEC. 3.05 PROPOSED PAYMENT PROCEDURES

SEC. 3.06 CONTRACT PAYMENT

SEC. 3.08 ELECTRONIC PAYMENTS

SEC. 3.07 LOCATION OF WORK

SEC. 3.08 SUBCONTRACTORS

SEC. 3.09 JOINT VENTURES

SEC. 3.10 RIGHT TO INSPECT PLACE OF BUSINESS

SEC. 3.11 CONTRACT PERSONNEL

SEC. 3.12 INSPECTION & MODIFICATION - REIMBURSEMENT FOR UNACCEPTABLE DELIVERABLES

SEC. 3.13 CONTRACT CHANGES - UNANTICIPATED AMENDMENTS

SEC. 3.14 NONDISCLOSURE AND CONFIDENTIALITY

SEC. 3.15 INDEMNIFICATION

SEC. 3.16 INSURANCE REQUIREMENTS

SEC. 3.17 TERMINATION FOR DEFAULT

SECTION 4. PROPOSAL FORMAT AND CONTENT

SEC. 4.01 RFP SUBMITTAL FORMS

SEC. 4.02 SPECIAL FORMATTING REQUIREMENTS

SEC. 4.03 OFFEROR INFORMATION AND CERTIFICATIONS (SUBMITTAL FORM A)

SEC. 4.04 EXPERIENCE AND QUALIFICATIONS (SUBMITTAL FORM B)

SEC. 4.05 UNDERSTANDING OF THE PROJECT (SUBMITTAL FORM C)

SEC. 4.06 METHODOLOGY USED FOR THE PROJECT (SUBMITTAL FORM D)

SEC. 4.07 MANAGEMENT PLAN FOR THE PROJECT (SUBMITTAL FORM E)

SEC. 4.08 INTERVIEWS

SEC. 4.09 COST PROPOSAL (SUBMITTAL FORM F)

SECTION 5. EVALUATION CRITERIA AND CONTRACTOR SELECTION

SEC. 5.01 SUMMARY OF EVALUATION PROCESS

SEC. 5.02 EVALUATION CRITERIA

SEC. 5.03 SCORING METHOD AND CALCULATION

SEC. 5.04 EXPERIENCE AND QUALIFICATIONS

SEC. 5.05 UNDERSTANDING OF THE PROJECT

SEC. 5.06 METHODOLOGY USED FOR THE PROJECT

SEC. 5.07 MANAGEMENT PLAN FOR THE PROJECT

SEC. 5.08 INTERVIEWS

SEC. 5.09 CONTRACT COST (COST PROPOSAL)

SEC. 5.10 ALASKA OFFEROR PREFERENCE

SECTION 6. GENERAL PROCESS AND LEGAL INFORMATION

SEC. 6.01 INFORMAL DEBRIEFING

SEC. 6.02 ALASKA BUSINESS LICENSE AND OTHER REQUIRED LICENSES

SEC. 6.03 SITE INSPECTION

SEC. 6.04 CLARIFICATION OF OFFERS

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SEC. 6.05 DISCUSSIONS WITH OFFERORS

SEC. 6.06 EVALUATION OF PROPOSALS

SEC. 6.07 CONTRACT NEGOTIATION

SEC. 6.08 FAILURE TO NEGOTIATE

SEC. 6.09 OFFEROR NOTIFICATION OF SELECTION

SEC. 6.10 PROTEST

SEC. 6.11 APPLICATION OF PREFERENCES

SEC. 6.12 ALASKA BIDDER PREFERENCE

SEC. 6.13 ALASKA VETERAN PREFERENCE

SEC. 6.14 ALASKA MILITARY SKILLS PROGRAM PREFERENCE

SEC. 6.15 STANDARD CONTRACT PROVISIONS

SEC. 6.16 QUALIFIED OFFERORS

SEC. 6.17 PROPOSAL AS PART OF THE CONTRACT

SEC. 6.18 ADDITIONAL TERMS AND CONDITIONS

SEC. 6.19 HUMAN TRAFFICKING

SEC. 6.20 RIGHT OF REJECTION

SEC. 6.21 STATE NOT RESPONSIBLE FOR PREPARATION COSTS

SEC. 6.22 DISCLOSURE OF PROPOSAL CONTENTS

SEC. 6.23 ASSIGNMENT

SEC. 6.24 FORCE MAJEURE (IMPOSSIBILITY TO PERFORM)

SEC. 6.25 DISPUTES

SEC. 6.26 SEVERABILITY

SEC. 6.27 SUPPLEMENTAL TERMS AND CONDITIONS

SEC. 6.28 SOLICITATION ADVERTISING

SEC. 6.29 FEDERALLY IMPOSED TARIFFS

SECTION 7. ATTACHMENTS

SEC. 7.01 ATTACHMENTS

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INTRODUCTION & INSTRUCTIONS

SEC. 1.01 PURPOSE OF THE RFP

The Department of Administration, Office of Administrative Hearings, is soliciting proposals for services to provide efficient and cost effective fast-track mediation services negotiated between Department of Health and unrepresented individuals relevant to disputed Medicaid services and coverage.

SEC. 1.02 BUDGET

The Department of Administration, Office of Administrative Hearings, estimates a budget of between $350,000.00 and $380,000.00 dollars for completion of this project. Proposals priced at more than $400,000.00 will be considered non-responsive.

Payment for the contract is subject to funds already appropriated and identified.

SEC. 1.03 DEADLINE FOR RECEIPT OF PROPOSALS

Proposals must be received no later than 2:00 PM prevailing Alaska Time on October 31, 2025, as indicated by postmark or email timestamp and late proposals will not be considered.

SEC. 1.04 PRIOR EXPERIENCE

In order for offers to be considered responsive offerors must meet these minimum prior experience requirements:

• Must have at least three years of experience providing professional mediation, arbitration, or other alternative dispute resolution services in which a federal, tribal, territorial or state agency is a regular party; if the offeror is a firm, the individual(s) assigned to the mediation services must also have at least three years’ experience providing these services.

• Must have at least three years of experience with Medicare or Medicaid law and the provision of benefits to individuals, providing subject matter expertise; if the offeror is a firm, the individual(s) assigned to the mediation services must also have at least three years’ experience with the applicable laws and provisions.

• Must have at least one of the following for the individual(s) assigned to the mediation services:

o professional certification to act as a mediator, demonstrable with a credential from a trade organization of professional mediators;

o an active law license; or o proof of completion of a post-secondary academic program specific to mediation or other alternative dispute resolution processes.

An offeror's failure to meet these minimum prior experience requirements will cause their proposal to be considered non-responsive and rejected.

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SEC. 1.05 REQUIRED REVIEW

Offerors should carefully review this solicitation for defects and questionable or objectionable material.

Comments concerning defects and questionable or objectionable material should be made in writing and received by the procurement officer at least ten days before the deadline for receipt of proposals.

This will allow time for the issuance of any necessary amendments. It will also help prevent the opening of a defective proposal and exposure of offeror's proposals upon which award cannot be made.

SEC. 1.06 QUESTIONS PRIOR TO DEADLINE FOR RECEIPT OF PROPOSALS

All questions must be in writing and directed to the procurement officer. The interested party must confirm telephone conversations in writing.

Two types of questions generally arise. One may be answered by directing the questioner to a specific section of the RFP. These questions may be answered over the telephone. Other questions may be more complex and may require a written amendment to the RFP. The procurement officer will make that decision.

CONTRACTING OFFICER: Christine Mash – EMAIL: doa.oppm.procurement@alaska.gov

SEC. 1.07 RETURN INSTRUCTIONS

Offerors must submit their proposal via email, the technical proposal and cost proposal must be saved as separate PDF documents and emailed to doa.oppm.procurement@alaska.gov as separate, clearly labeled attachments, such as “Vendor A – Technical Proposal.pdf” and “Vendor A – Cost Proposal.pdf”.

The email must contain the RFP number in the subject line.

The maximum size of a single email (including all text and attachments) that can be received by the state is 20mb (megabytes). If the email containing the proposal exceeds this size, the proposal must be sent in multiple emails that are each less than 20 megabytes and each email must comply with the requirements described above.

Please note that email transmission is not instantaneous. Similar to sending a hard copy proposal, if you are emailing your proposal, the state recommends sending it with enough time to ensure the email is delivered by the deadline for receipt of proposals.

It is the offeror’s responsibility to contact the issuing agency at doa.oppm.procurement@alaska.gov to confirm that the proposal has been received. The state is not responsible for unreadable, corrupt, or missing attachments.

SEC. 1.08 ASSISTANCE TO OFFERORS WITH A DISABILITY

Offerors with a disability may receive accommodation regarding the means of communicating this RFP or participating in the procurement process. For more information, contact the procurement officer no later than ten days prior to the deadline for receipt of proposals.

mailto:doa.oppm.procurement@alaska.gov

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SEC. 1.09 AMENDMENTS TO PROPOSALS

Amendments to or withdrawals of proposals will only be allowed if acceptable requests are received prior to the deadline that is set for receipt of proposals. No amendments or withdrawals will be accepted after the deadline unless they are in response to the state's request in accordance with 2 AAC 12.290.

SEC. 1.10 AMENDMENTS TO THE RFP

If an amendment is issued before the deadline for receipt of proposals, the amendment will be posted on the State of Alaska Online Public Notice (OPN) website. The link to the posting of the amendment will be provided to all who were notified of the RFP and to those who have registered with the procurement officer after receiving the RFP from the OPN.

After receipt of proposals, if there is a need for any substantial clarification or material change in the RFP, an amendment will be issued. The amendment will incorporate the clarification or change, and a new date and time established for new or amended proposals. Evaluations may be adjusted as a result of receiving new or amended proposals.

SEC. 1.11 RFP SCHEDULE

RFP schedule set out herein represents the state’s best estimate of the schedule that will be followed. If a component of this schedule, such as the deadline for receipt of proposals, is delayed, the rest of the schedule may be shifted accordingly. All times are Alaska Time.

ACTIVITY TIME DATE

Issue Date / RFP Released September 23, 2025 Last Day for Questions October 13, 2025 Deadline for Receipt of Proposals / Proposal Due Date 3:00 PM AKST October 31, 2025 Initial Proposal Evaluation Meeting (approximately week of) November 17, 2025 Interviews (approximately week of) November 24, 2025 Proposal Evaluations Complete (approximately week of) November 24, 2025 Negotiations (approximately week of) December 1, 2025 Notice of Intent to Award (approximately week of) December 19, 2025 Contract Issued January 1, 2026

This RFP does not, by itself, obligate the state. The state's obligation will commence when the contract is approved by the Commissioner of the Department of Administration, or the Commissioner's designee.

Upon written notice to the contractor, the state may set a different starting date for the contract. The state will not be responsible for any work done by the contractor, even work done in good faith, if it occurs prior to the contract start date set by the state.

SEC. 1.12 ALTERNATE PROPOSALS

Offerors may only submit one proposal for evaluation. In accordance with 2 AAC 12.830 alternate proposals (proposals that offer something different than what is asked for) will be rejected.

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SEC. 1.13 NEWS RELEASES

News releases related to this RFP will not be made without prior approval of the project director.

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SECTION 2. BACKGROUND INFORMATION

SEC. 2.01 BACKGROUND INFORMATION

The Department of Administration (DOA), Office of Administrative Hearings (OAH), uses a fast-track mediation program, modeled on an early mediation system for Medicaid appeals developed for the State of North Carolina. A short article about the North Carolina program can be found at:

https://www.americanbar.org/groups/law_aging/publications/bifocal/vol_35/issue_3_feb2014/ mediation_medicaid_appeals_program/.

The fast-track mediation program has been utilized by the State of Alaska since 2016. It provides an early opportunity to resolve fair hearing requests made to the Department of Health (DOH) Division of Senior and Disabilities Services and the Division of Health Care Services. The fast-track mediation program is designed to either resolve fair hearing requests in claimants’ favor or educate potential claimants about statutory or regulatory restrictions to coverage that in turn result in the withdrawal of the fair hearing request. In either case, the costs of the fair hearings are kept to a minimum, and potentially reduce costs to various Medicaid programs, by shortening the appeal time and the coverage of expenses during that period.

In 2024, 316 cases entered into fast-track mediation; 82% were resolved within 14 days of the hearing request. Cases in the calendar year 2025 are on equal pace to prior years of mediation service. Due to the success of this program, DOH has approved expanding fast-track mediation to both eligibility and extent-of-coverage cases.

Since 2016, DOA OAH has utilized a sole proprietary database with the current vendor. With the current contract expiring at the end of the year, DOA OAH has elected to use the State of Alaska databases for case management, including Prolaw, and other programs identified, populated, and maintained by

DOH.

https://www.americanbar.org/groups/law_aging/publications/bifocal/vol_35/issue_3_feb2014/%E2%80%8C%E2%80%8C%E2%80%8C%E2%80%8Cmediation_medicaid_appeals_program/ https://www.americanbar.org/groups/law_aging/publications/bifocal/vol_35/issue_3_feb2014/%E2%80%8C%E2%80%8C%E2%80%8C%E2%80%8Cmediation_medicaid_appeals_program/

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SECTION 3. SCOPE OF WORK & CONTRACT INFORMATION

SEC. 3.01 SCOPE OF WORK

The Department of Administration (DOA), Office of Administrative Hearings (OAH), is soliciting proposals for a fast-track mediation program as outlined below:

In advance of a contested hearing, the offeror must conduct fast-track mediations between unrepresented individuals, fair hearing representatives with the Alaska Department of Health (DOH), and potentially others as described below concerning appealed denials of Medicaid coverage claims. The fast-track mediation process is as follows:

• The Division of Senior and Disabilities Services (SDS) is the state division within DOH that ensures the State of Alaska meets the health needs of seniors, people with disabilities, and vulnerable adults. SDS fulfills this mission by managing Medicaid’s coverage and payment for various services for these populations and determining an individual’s eligibility for those services.

• Similarly, the DOH Division of Health Care Services (HCS) provides additional access and oversight to a range of Medicaid services to all eligible Alaskans.

• Depending on the Medicaid program at issue or the eligibility of an individual, either SDS or HCS makes an initial decision regarding Medicaid benefit coverage for that individual.

• If SDS or HCS denies coverage for a service or to an individual, the applicable division notifies the individual of the denial and informs the individual of his or her right to a fair hearing challenging that denial.

• The individual or their legal representative requests a fair hearing. The fair hearing request must identify if the individual is represented by legal counsel. If the individual would like other case parties to receive case documents, the individual must identify this in writing and provide the other case parties’ mailing address, email, or fax information for the receipt of the case documents.

• When an individual requests a fair hearing, either SDS or HCS, as applicable to the program or the individual, refers the fair hearing request to OAH.

• If the individual that has requested a fair hearing is represented by legal counsel, the individual’s fair hearing request is assigned by OAH to an OAH administrative law judge for a fair hearing.

These cases are not eligible for fast-track mediation.

• If an individual who has requested a fair hearing is not represented by legal counsel, the individual’s fair hearing request is eligible for fast-track mediation.

o SDS has elected that all of its referrals go to fast-track mediation and SDS sends the referrals requesting that the individual automatically be scheduled for mediation.

Individuals can opt out of fast-track mediation by requesting fair hearing from OAH.

o HCS informs OAH during referral if HCS has elected to refer the case for fast-track mediation, and OAH assigns the case to fast-track mediation or a fair hearing depending on HCS’s election.

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• Upon SDS’s or HCS’s referral of a Medicaid program hearing request to OAH, OAH staff send the individual who requested the hearing a notice, which identifies the administrative law judge assigned to the individual’s case as well as a written notice of the scheduled mediation session.

The notice informs the individual that participation is voluntary and explains how they may opt out of mediation. If an individual opts out, the matter is immediately scheduled for a fair hearing before the assigned administrative law judge.

• The mediation session, identified in the notice, is scheduled to occur within two weeks of the fair hearing referral. Mediation sessions must occur between 9:00 AM AKST and 4:00 PM AKST, and up to seven mediation sessions may be scheduled per day; the State does not guarantee a minimum or maximum number of mediation sessions per day. The mediation sessions are scheduled for two full days and one-half day each week, subject to changes based on the volume of appeals and the availability of DOH hearing representatives. The availability of the DOH hearing representatives is the primary factor in determining the days each week that mediation sessions will occur.

• The offeror must provide two weeks’ notice of expected unavailability for vacations or other purposes. OAH will accommodate the unavailability of the offeror for up to three weeks each calendar year.

• Prior to mediation sessions, the offeror must work with OAH to ensure against the unlikelihood that there may be a conflict of interest, which might require the recusal of the individual assigned to the mediation for a specific matter. In the case of recusal, OAH will assign the case to hearing track.

• OAH will work with SDS or HCS to determine if a language interpreter might be necessary for the mediation. OAH is responsible for and will provide an interpreter, if applicable.

• Approximately two weeks after the referral and notice, the parties participate in a mediation session with the offeror.

• For expedited requests subject to 42 CFR § 431.224, the offeror must have the ability to schedule and hear expedited mediation sessions within three business days. OAH’s Chief Administrative Law Judge or their delegate reviews all expedited appeals requests to determine if they qualify under 42 CFR § 431.224. If the individual qualifies, the offeror must be able to schedule the expedited mediation session within three business days. If the request does not qualify, OAH will provide notice to the individual.

• The mediation sessions do not occur in person. The offeror must be able to conduct the sessions telephonically or by Microsoft Teams or Zoom.

• The mediation sessions generally last 45 minutes per mediation. The participants included in the mediation sessions on behalf of the individual include, but are not limited to:

o the Medicaid recipient o a parent, guardian, or individual with power of attorney for the individual o a care coordinator o a personal care assistant o other family members

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o DOH participants include a DOH fair hearing representative and may include DOH program staff as well.

o A language interpreter may also be present, if applicable.

• The mediation concludes with either a settlement and a decision by the recipient to withdraw the appeal or an impasse. If a mediation session is not completed due to additional information requested or additional participation is required; a follow-up mediation session or sessions must be scheduled by the offeror. The offeror must provide OAH with the follow-up mediation session’s scheduled date and OAH staff will send out a notice to the individual.

• Mediation discussions themselves are not recorded. However, records of settlements and withdrawals of fair hearing requests must be recorded. Currently, OAH utilizes the commercially available Soniclear recording system. The offeror must utilize Soniclear, or any other recording system OAH may identify during the contract term. OAH will provide access and training to the offeror to use the recording system identified by OAH, including the storage of the recording. An administrative law judge is assigned to review all recordings and issue notices of dismissal, if warranted.

• The offeror must report on the terms of successful mediations to OAH within three business days for recordings to be reviewed, and dismissals entered.

• If a mediation session is not successful, the offeror must report unsuccessful mediations to OAH within one business day so a timely hearing may be scheduled.

Because of the fast-paced nature of these mediations, the offeror must have a working knowledge of the following statutes and regulations:

• Alaska Statute 47.07.010 et. seq. (Medical Assistance for Needy Persons), 7 AAC 47 (General Relief and General Relief Medical), 7 AAC 100 (Medicaid Eligibility), 7 AAC 105.100 to 160.990 (Medicaid Coverage and Payment);

• 7 AAC 49 (Hearings);

• Alaska Statute 44.64 (OAH jurisdiction), 2 AAC 64 (Hearing Procedures);

• 42 USC 1396a (State Plans for Medical Assistance);

• 42 CFR 409.33 (Home and Community Based Waivers);

• 42 CFR 431.51 & 431.54; 456.3 (Relating to Care Management Program);

• 42 CFR 435.540 (TEFRA Waiver – Children with Severe Disabilities);

• 42 CFR 440.1 – 185 (general federal Medicaid requirements), 42 CFR 431.220 – 223 (hearing requirements);

• 42 CFR 447.10, 447.15 & 447.45 (Claims payment restrictions and requirements); and

• Any and all laws or regulations impacting Medicaid eligibility and extent of coverage determinations.

• Prior experience with the laws and the provisions of Medicaid benefits program in Alaska is preferred.

The offeror shall have access to confidential information, including confidential protected health information through OAH’s case management system, Prolaw. OAH will provide the offeror with access

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to Prolaw and train the offeror on its use. When the offeror accesses beneficiary information, it must be maintained in compliance with HIPAA and the State of Alaska Personal Information Protection Act codified at Alaska Statute Title 45, Chapter 48. A summary of the state law obligations can be found at:

https://www.akleg.gov/basis/get_documents.asp?session=29&docid=65934.

REPORTING

The offeror must report deidentified metrics regarding measurable elements on the success of the mediation process to DOH on a monthly basis and to OAH annually. All deidentified data requested shall be retrievable from the offeror, based on management of the fast-track mediation, or from Prolaw.

Requested metrics include, but are not limited to:

• Number of cases referred to mediation

• Number of cases actually heard in mediation

• Number of mediated cases that resulted in a withdrawal of the fair hearing request

• Number of cases referred to hearing after unsuccessful mediation

• Number of no-shows for the mediation sessions

• Number of days between assignment of mediation to closure of the case

• Average mediation length by case type

• Successful mediation rate by case type

• Administrative costs of mediation

• Days of continued benefits during mediation for each case type

• Additional retrievable metrics requested by DOH or OAH to monitor success of the fast-track mediation program

The offeror must submit the OAH annual report on January 15th (or the next business day should the 15th fall on a weekend or holiday) following the calendar year being analyzed. The results of that report will be included as part of the OAH’s Chief’s annual report to the Alaska State Legislature, due January 31st of each year. No report is due to OAH in the first term of the contract. If the contract is not renewed for an additional term, the offeror’s report must be submitted on January 15th, addressing last year’s activities.

The offeror is not required to maintain any proprietary database for monitoring these metrics. Any data the offeror may mine, gather, or report is the property of DOH or OAH, not the offeror. At the time of contract termination, any collected or extracted data by the offeror shall be returned to OAH, upon OAH’s request. Both DOH and OAH maintain the right to inspect and validate the offeror’s collected or extracted data, upon request.

OAH MEDIATION TRAINING

OAH may eventually take this work in-house in whole or in part, depending on its own election in consultation with DOH; the offeror must provide training to OAH administrative law judges through shadowing and participation in the mediation sessions.

https://www.akleg.gov/basis/get_documents.asp?session=29&docid=65934

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ANTICIPATED AMENDMENT

If OAH chooses, OAH may execute an anticipated amendment with the successful offeror to assist OAH with fast-track mediations for Medicaid eligibility coverage determinations for the DOH, Division of Public Assistance (DPA). The offeror shall be compensated for these additional services at the case rates proposed for this RFP and collected on the Cost Proposal Form (Submittal Form F).

DPA is the state division that ensures the State of Alaska enrolls all qualified Medicaid applicants into the correct Medicaid category for which they are eligible. DPA maintains and continues the enrollment of all qualified Medicaid recipients. This anticipated amendment would include fast-track mediation for related Medicaid eligibility coverage determinations.

SEC. 3.02 CONTRACT TERM AND WORK SCHEDULE

The length of the contract for conducting mediation sessions will be from January 1, 2026, through December 31, 2026, with three one-year renewal options at the state’s discretion. If OAH elects not to exercise a one-year renewal, the offeror must provide its annual report by January 15, 2027.

Unless otherwise provided in this RFP, the State and the successful offeror/contractor agree: (1) that any extension of the contract excluding any exercised renewal options, will be considered as a month-to-month extension, and all other terms and conditions shall remain in full force and effect and (2) the procurement officer will provide notice to the contractor of the intent to cancel such month-to-month extension at least 30 days before the desired date of cancellation. A month-to-month extension may only be executed by the procurement officer via a written contract amendment.

SEC. 3.03 DELIVERABLES

The offeror must provide the following deliverables:

• The offeror must provide efficient and cost effective fast-track mediation services negotiated between DOH and unrepresented individuals relevant to disputed Medicaid services and coverage.

• The offeror must have the ability to schedule and hear expedited appeals, subject to 42 CFR § 431.224, within three business days.

• The offeror must report on the terms of successful mediations to OAH within three business days so recordings may be reviewed, and dismissals entered by OAH.

• The offeror must report unsuccessful mediations to OAH within one business day so cases may be reassigned and OAH may schedule timely hearings.

• The offeror must provide an annual report to OAH summarizing the results of mediations on a calendar year basis, due on January 15th (or the next business day should the 15th fall on a weekend or holiday). The results of that report will be included as part of the OAH’s Chief’s annual report to the Alaska State Legislature, due January 31st of each year. No report is due to OAH in the first term of the contract. If the contract is not renewed for an additional term, the offeror’s report must be submitted on January 15th, addressing last year’s activities.

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• The offeror must provide training to OAH Administrative Law Judges through shadowing and participation in the mediation sessions.

SEC. 3.04 CONTRACT TYPE

This contract is a Time and Materials contract.

SEC. 3.05 PROPOSED PAYMENT PROCEDURES

The state will make monthly payments when all of the deliverables are received, and throughout the life of the contract. Each billing must consist of an invoice and itemized detail of supporting services. No payment will be made until the progress report and invoice has been approved by the project director.

SEC. 3.06 CONTRACT PAYMENT

No payment will be made until the contract is approved by the Commissioner of the Department of Administration or the Commissioner's designee. Under no conditions will the state be liable for the payment of any interest charges associated with the cost of the contract. The state is not responsible for and will not pay local, state, or federal taxes. All costs associated with the contract must be stated in U.S.

currency.

Payment for agreements under $500,000 for the undisputed purchase of goods or services provided to a state agency, will be made within 30 days of the receipt of a proper billing or the delivery of the goods or services to the location(s) specified in the agreement, whichever is later. A late payment is subject to 1.5% interest per month on the unpaid balance. Interest will not be paid if there is a dispute or if there is an agreement that establishes a lower interest rate or precludes the charging of interest.

SEC. 3.08 ELECTRONIC PAYMENTS

The State of Alaska prefers vendors receive payment via Electronic Funds Transfer (EFT). Offerors may review information concerning the EFT process and access the Electronic Payment Agreement Form for Vendors at the following link: https://doa.alaska.gov/dof/vendor.html. Method of payment is not a factor in the State’s determination for award.

Any single contract payment of $1 million or higher must be accepted by the contractor via Electronic Funds Transfer (EFT).

SEC. 3.07 LOCATION OF WORK

The location(s) the work is to be performed, completed, and managed is at the offeror’s location with mediations occurring telephonically or by Microsoft Teams or Zoom.

The state will not provide workspace for the contractor. The contractor must provide its own workspace.

By signing their proposal, the offeror certifies that all services provided under this contract by the contractor and all subcontractors shall be performed in the United States.

https://doa.alaska.gov/dof/vendor.html

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If the offeror cannot certify that all work will be performed in the United States, the offeror must contact the procurement officer in writing to request a waiver at least 10 days prior to the deadline for receipt of proposals.

The request must include a detailed description of the portion of work that will be performed outside the United States, where, by whom, and the reason the waiver is necessary.

Failure to comply with these requirements may cause the state to reject the proposal as non-responsive or cancel the contract.

SEC. 3.08 SUBCONTRACTORS

Subcontractors will not be allowed.

SEC. 3.09 JOINT VENTURES

Joint ventures will not be allowed.

SEC. 3.10 RIGHT TO INSPECT PLACE OF BUSINESS

At reasonable times, the state may inspect those areas of the contractor's place of business that are related to the performance of a contract. If the state makes such an inspection, the contractor must provide reasonable assistance.

SEC. 3.11 CONTRACT PERSONNEL

Any change of the project team members named in the proposal must be approved, in advance and in writing, by the project director and the procurement officer. Changes that are not approved by the state may be grounds for the state to terminate the contract.

SEC. 3.12 INSPECTION & MODIFICATION - REIMBURSEMENT FOR UNACCEPTABLE

DELIVERABLES

The contractor is responsible for the completion of all work set out in the contract. All work is subject to inspection, evaluation, and approval by the project director. The state may employ all reasonable means to ensure that the work is progressing and being performed in compliance with the contract. The project director or procurement officer may instruct the contractor to make corrections or modifications if needed in order to accomplish the contract’s intent. The contractor will not unreasonably withhold such changes.

Substantial failure of the contractor to perform the contract may cause the state to terminate the contract. In this event, the state may require the contractor to reimburse monies paid (based on the identified portion of unacceptable work received) and may seek associated damages.

SEC. 3.13 CONTRACT CHANGES - UNANTICIPATED AMENDMENTS

During the course of this contract, the contractor may be required to perform additional work. That work will be within the general scope of the initial contract. When additional work is required, the project

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director will provide the contractor a written description of the additional work and request the contractor to submit a firm time schedule for accomplishing the additional work and a firm price for the additional work. Cost and pricing data must be provided to justify the cost of such amendments per AS 36.30.400.

The contractor will not commence additional work until the procurement officer has secured any required state approvals necessary for the amendment and issued a written contract amendment, approved by the Commissioner of the Department of Administration or the Commissioner's designee.

SEC. 3.14 NONDISCLOSURE AND CONFIDENTIALITY

Contractor agrees that all confidential information shall be used only for purposes of providing the deliverables and performing the services specified herein and shall not disseminate or allow dissemination of confidential information except as provided for in this section. The contractor shall hold as confidential and will use reasonable care (including both facility physical security and electronic security) to prevent unauthorized access by, storage, disclosure, publication, dissemination to and/or use by third parties of, the confidential information. “Reasonable care” means compliance by the contractor with all applicable federal and state law, including the Social Security Act and HIPAA. The contractor must promptly notify the state in writing if it becomes aware of any storage, disclosure, loss, unauthorized access to or use of the confidential information.

Confidential information, as used herein, means any data, files, software, information or materials (whether prepared by the state or its agents or advisors) in oral, electronic, tangible or intangible form and however stored, compiled or memorialized that is classified confidential as defined by State of Alaska classification and categorization guidelines provided by the state to the contractor or a contractor agent or otherwise made available to the contractor or a contractor agent in connection with this contract, or acquired, obtained or learned by the contractor or a contractor agent in the performance of this contract. Examples of confidential information include, but are not limited to: technology infrastructure, architecture, financial data, trade secrets, equipment specifications, user lists, passwords, research data, and technology data (infrastructure, architecture, operating systems, security tools, IP addresses, etc).

Additional information that the contractor shall hold as confidential during the performance of services under this contract include:

Information in each of these mediations concerns the delivery of health care services and as such contain confidential personally identifiable information and confidential health and financial information. The offeror must be able to maintain the confidentiality of this information in compliance with Federal and State law.

If confidential information is requested to be disclosed by the contractor pursuant to a request received by a third party and such disclosure of the confidential information is required under applicable state or federal law, regulation, governmental or regulatory authority, the contractor may disclose the confidential information after providing the state with written notice of the requested disclosure ( to

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the extent such notice to the state is permitted by applicable law) and giving the state opportunity to review the request. If the contractor receives no objection from the state, it may release the confidential information within 30 days. Notice of the requested disclosure of confidential information by the contractor must be provided to the state within a reasonable time after the contractor’s receipt of notice of the requested disclosure and, upon request of the state, shall seek to obtain legal protection from the release of the confidential information.

The following information shall not be considered confidential information: information previously known to be public information when received from the other party; information freely available to the general public; information which now is or hereafter becomes publicly known by other than a breach of confidentiality hereof; or information which is disclosed by a party pursuant to subpoena or other legal process and which as a result becomes lawfully obtainable by the general public.

SEC. 3.15 INDEMNIFICATION

The contractor shall indemnify, hold harmless, and defend the contracting agency from and against any claim of, or liability for error, omission, or negligent act of the contractor under this agreement. The contractor shall not be required to indemnify the contracting agency for a claim of, or liability for, the independent negligence of the contracting agency. If there is a claim of, or liability for, the joint negligent error or omission of the contractor and the independent negligence of the contracting agency, the indemnification and hold harmless obligation shall be apportioned on a comparative fault basis.

“Contractor” and “contracting agency”, as used within this and the following article, include the employees, agents and other contractors who are directly responsible, respectively, to each. The term “independent negligence” is negligence other than in the contracting agency’s selection, administration, monitoring, or controlling of the contractor and in approving or accepting the contractor’s work.

SEC. 3.16 INSURANCE REQUIREMENTS

Without limiting contractor's indemnification, it is agreed that contractor shall purchase at its own expense and maintain in force at all times during the performance of services under this agreement the following policies of insurance. Where specific limits are shown, it is understood that they shall be the minimum acceptable limits. If the contractor's policy contains higher limits, the state shall be entitled to coverage to the extent of such higher limits.

Certificates of Insurance must be furnished to the procurement officer prior to beginning work and must provide for a notice of cancellation, non-renewal, or material change of conditions in accordance with policy provisions. Failure to furnish satisfactory evidence of insurance or lapse of the policy is a material breach of this contract and shall be grounds for termination of the contractor's services. All insurance policies shall comply with and be issued by insurers licensed to transact the business of insurance under

AS 21.

Workers' Compensation Insurance: The contractor shall provide and maintain, for all employees engaged in work under this contract, coverage as required by AS 23.30.045, and where

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applicable, any other statutory obligations including but not limited to Federal U.S.L. & H. and Jones Act requirements. The policy must waive subrogation against the State.

Commercial General Liability Insurance: covering all business premises and operations used by the Contractor in the performance of services under this agreement with minimum coverage limits of $300,000 combined single limit per claim.

Commercial Automobile Liability Insurance: covering all vehicles used by the contractor in the performance of services under this agreement with minimum coverage limits of $300,000 combined single limit per claim.

Professional Liability Insurance: covering all errors, omissions, or negligent acts in the performance of professional services under this agreement. Limits required per the following schedule:

Contract Amount Minimum Required Limits

Under $100,000 $300,000 per Claim/Annual Aggregate $100,000-$499,000 $500,000 per Claim/Annual Aggregate $500,000-$999,999 $1,000,000 per Claim/Annual Aggregate

SEC. 3.17 TERMINATION FOR DEFAULT

a. If the Project Director or Procurement Officer determines that the contractor has refused to perform the work or has failed to perform the work with such diligence as to ensure its timely and accurate completion, the state may, by providing written notice to the contractor, terminate the contractor's right to proceed with part or all the remaining work.

b. The Procurement Officer may also, by written notice, terminate this contract under Administrative Order 352 if the contractor supports or participates in a boycott of the State of Israel.

This clause does not restrict the state's termination rights under the contract provisions of Appendix A, attached in SECTION 7. ATTACHMENTS.

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SECTION 4. PROPOSAL FORMAT AND CONTENT

SEC. 4.01 RFP SUBMITTAL FORMS

This RFP contains Submittal Forms, which must be completed by the offeror and submitted as part of their proposal. An electronic copy of the forms is posted along with this RFP.

Unless otherwise specified in this RFP, the Submittal Forms shall be the offeror’s entire proposal. Do not include any marketing information in the proposal.

Any proposal that does not follow these requirements may be deemed non-responsive.

SEC. 4.02 SPECIAL FORMATTING REQUIREMENTS

The offeror must ensure that their proposal meets all special formatting requirements identified in this section.

Documents and Text: All attachment documents must be written in the English language, be single sided, and be single spaced with a minimum font size of 10. Pictures or graphics may be used if the offeror feels it is necessary to communicate their information, however, be aware of the below requirements for page limits.

Page Limits: Some Submittal Forms listed below have maximum page limit requirements. Offerors must not exceed the maximum page limits. Note, the page limit applies to the front side of a page only (for example, ‘1 Page’ implies that the offeror can only provide a response on one side of a piece of paper). Any pages exceeding the maximum page limit will be discarded and will not be included in the evaluations (for example, the maximum page limit is 3 pages, but the Offeror submits 5 pages for that submittal form. Only pages 1-3 will be evaluated. Pages 4 and 5 would be discarded by the Procurement Officer before sending to the proposal evaluation committee for evaluation.).

Submittal Form Maximum Page Limits

Submittal Form A – Offeror Information and Certifications Submittal Form B – Experience and Qualifications 3

Submittal Form C – Understanding of the Project 3 Submittal Form D – Methodology Used for the Project 5 Submittal Form E – Management Plan for the Project 5 Submittal Form F – Cost Proposal

Any Submittal Form submitted as part of a proposal that is not compliant with the instructions above may be a basis for finding the proposal non-responsive and thus rejected.

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SEC. 4.03 OFFEROR INFORMATION AND CERTIFICATIONS (SUBMITTAL FORM A)

The offeror must complete and submit this Submittal Form. The form must be signed by an individual authorized to bind the offeror to the provisions of the RFP.

By signature on the form, the offeror certifies they comply with the following:

a) the laws of the State of Alaska;

b) the applicable portion of the Federal Civil Rights Act of 1964;

c) the Equal Employment Opportunity Act and the regulations issued thereunder by the federal government;

d) the Americans with Disabilities Act of 1990 and the regulations issued thereunder by the federal government and certifies that programs, services, and activities provided to the general public on behalf of the State under a contract resulting from this solicitation comply with the Americans with Disabilities Act of 1990, 28 CFR, Part 35, Subpart B 35.130;

e) all terms and conditions set out in this RFP;

f) a condition that the proposal submitted was independently arrived at, without collusion, under penalty of perjury; and

g) that the offers will remain open and valid for at least 90 days.

If any offeror fails to comply with [a] through [g] of this paragraph, the state reserves the right to disregard the proposal, terminate the contract, or consider the contractor in default.

The Submittal Form also requests the following information:

a) The complete name and address of offeror’s firm along with the offeror’s Tax ID.

b) Information on the person the state should contact regarding the proposal.

c) Names of critical team members/personnel.

d) Addenda acknowledgement.

e) Conflict of interest statement.

f) Federal requirements.

g) Alaska preference qualifications.

An offeror's failure to address/respond/include these items may cause the proposal to be determined to be non-responsive and the proposal may be rejected.

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SEC. 4.04 EXPERIENCE AND QUALIFICATIONS (SUBMITTAL FORM B)

Offerors must provide detail on the personnel assigned to accomplish the work called for in this RFP;

illustrate the lines of authority; designate the individual responsible and accountable for the completion of each component and deliverable of the RFP.

Offerors must provide a narrative description of the organization of the project team and a personnel roster that identifies each person who will actually work on the contract along with their titles and location(s) where work will be performed. For each individual that will conduct the mediations, the offeror must describe the individual’s experience as set out in Sec. 1.04.

If applicable, offerors must provide details of any prior experience with the laws and the provisions of the Medicaid benefits program in Alaska. While not mandatory, prior Alaska-specific experience is preferred and will be scored one additional point during evaluation.

Offerors must also provide three Client Reference Forms, attached to this RFP, which provide reference names and phone numbers for similar projects the offeror’s firm has completed.

The offeror shall not disclose their costs in this Submittal Form. Submission forms shall not exceed the page limit (as described in Section 4.02).

Offerors must provide resumes for those personnel with names and title that will be assigned to complete the project as a separate attachment to Submittal Form B.

SEC. 4.05 UNDERSTANDING OF THE PROJECT (SUBMITTAL FORM C)

Offerors must provide comprehensive narrative statements that illustrate their understanding of the requirements of the project and the project schedule.

The offeror shall not disclose their costs in this Submittal Form. Submission forms shall not exceed the page limit (as described in Section 4.02).

SEC. 4.06 METHODOLOGY USED FOR THE PROJECT (SUBMITTAL FORM D)

Offerors must provide comprehensive narrative statements that set out the methodology they intend to employ and illustrate how the methodology will serve to accomplish the work and meet the state’s project schedule.

The offeror shall not disclose their costs in this Submittal Form. Submission forms shall not exceed the page limit (as described in Section 4.02).

SEC. 4.07 MANAGEMENT PLAN FOR THE PROJECT (SUBMITTAL FORM E)

Offerors must provide comprehensive narrative statements that set out the management plan they intend to follow and illustrate how the plan will serve to accomplish the work and meet the state's project schedule.

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The offeror shall not disclose their costs in this Submittal Form. Submission forms shall not exceed the page limit (as described in Section 4.02).

SEC. 4.08 INTERVIEWS

The state will conduct interviews with the offerors who have scored above the natural point break with the highest ranking after evaluation and scoring of technical proposals is completed. Interviews will be held with a representative or representatives of the offeror that must include individual(s) assigned to accomplish the work on Submittal Form B. No substitutes or proxies will be allowed. Individuals who fail to attend the interview at the date and time scheduled will be given a “0” score.

Each offeror’s interview will be scheduled for 60 minutes. Interviewees are prohibited from making any reference to their proposed cost/fee. Interviewees may bring notes for their personal use, but presentation materials or handouts to the reviewing panel may not be provided. Interviewees may be asked questions regarding their experience, knowledge and understanding of the scope of work, obstacles and challenges, strategies, and their plan/approach. The state may request additional information prior to interviews.

Interviews will be conducted via Microsoft Teams. If selected for an interview, the state will notify the offeror of the time and date the interview is scheduled. The state anticipates giving approximately five-day notice of interview date and time.

The State will…