RFP 26-87847.docx

This is a Pre-Proposal Network Opportunities Form submitted by Indiana Data Works LLC in response to RFP 26-87847 issued by the State of Indiana Department of Administration on behalf of the Family and Social Services Administration (FSSA) Office of Medicaid Policy and Planning. The RFP seeks an External Quality Review Organization (EQRO) to evaluate quality, timeliness, and access to healthcare services under Indiana's four Medicaid managed care programs: Hoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and Indiana PathWays for Aging Program. The contractor must be NCQA-certified for HEDIS and CAHPS activities and employ NCQA-certified HEDIS Compliance Auditors. Mandatory deliverables include performance measure validation, performance improvement project validation, MCO compliance reviews, network adequacy validation, MCO-specific and summary report cards, findings reports with recommendations, data workbooks, quarterly reports, monthly activity/status reports, and an annual technical report due to FSSA by March 1 and to CMS by April 30. A pre-proposal conference is scheduled for July 30, 2026, in Indianapolis with in-person and virtual attendance options. Proposals are due August 26, 2026, at 3:00 PM ET. Written questions are due by August 5, 2026, with responses posted by August 12. Evaluation is scheduled to begin September 1, with potential oral presentations on September 7 and award recommendation targeted for September 22. The contract term is four years from execution with two optional one-year renewal periods available, for a potential six-year total.

The cost proposal is scored on a 30-point scale using a normalization formula that favors the lowest cost, with all costs captured in a four-year bid amount including position titles and hourly billable rates. An Indiana Veteran Owned Small Business (IVOSB) subcontractor goal of 3% of total bid amount is scored up to 6 points, with an additional 5 points available for Indiana businesses qualifying under the Buy Indiana Initiative. The evaluation criteria total 90 points maximum (91 with bonus): 50 points for management assessment and quality and 30 for cost. The contractor must comply with HIPAA requirements under a Business Associate Agreement, Indiana IT security policies, and U.S. data center residency requirements with encryption, role-based access, SOC 2 audits, and 24/7 support. Liquidated damages of $1,000 per day apply for late or incomplete deliverables with a 10% payment withhold pending quarterly performance verification. All respondents must complete the Indiana Economic Impact Form and must not have had a state contract terminated for failure to perform within the last two calendar years. Indiana Data Works LLC, an IVOSB, submitted this form with contact information provided by Sylvia Saxena, Co-Owner and Principal of Health & Public Health Programs.