RFP 40DHHS-S2471 Procurement Support Services.docx

STATE OF NEVADA

DEPARTMENT OF ADMINISTRATION

Purchasing Division 515 East Musser Street, Suite 300 │ Carson City, NV 89701 Phone: 775-684-0170 │ Fax: 775-684-0188

Solicitation: 40DHHS-S2417 For Procurement Acquisition Support Services

Release Date: 09/12/2023 Deadline for Submission and Opening Date and Time: 10/30/2023 @ 2:00 pm

Single point of contact for the solicitation:

Ryan Vradenburg, Purchasing Officer III Phone, 775-684-0197 Email Address, rvradenburg@admin.nv.gov

(TTY for Deaf and Hard of Hearing, 800-326-6868 Ask the relay agent to dial, 1-775-684-0188/V.)

TABLE OF CONTENTS

APPLICABLE REGULATIONS GOVERNING PROCUREMENT

All applicable Nevada Revised Statutes (NRS) and Nevada Administrative Code (NAC) documentation can be found at: www.leg.state.nv.us/law1.cfm.

SINGLE POINT OF CONTACT. Vendors and/or their representatives shall only contact the single point of contract or use the electronic procurement system regarding this solicitation until after a notice of award (NOA) has been issued. Failure to observe this restriction may result in disqualification of a proposal per NAC 333.155(3).

Prospective vendors are advised to review Nevada’s ethical standards requirements, including but not limited to NRS 281A, NRS 333.800, and NAC 333.155.

PROJECT OVERVIEW

The State of Nevada Purchasing Division on behalf of the Department of Health and Human Services (DHHS) Division of Health Care Finance and Policy (DHCFP) is seeking a vendor to provide assistance with the procurement of Nevada’s Medicaid Managed Care Organization (MCO) program to ensure that the upcoming Request for Proposal (RFP) for the next managed care contracts are compliant with all State and Federal rules, regulations, and sub-regulatory guidance. DHCFP is expanding managed care access statewide effective January 1, 2026, DHCFP appreciates the critical importance of the re-procurement process and views it as an opportunity to improve the value of the state’s managed care system, further state health policy objectives, and ultimately improve the health care of Nevadans services as described in the scope of work and attachments.

The State intends to award one (1) contract in conjunction with this Request for Proposals (RFP), as determined in the best interests of the State. DHCFP shall administer contract resulting from this solicitation. The resulting contract are expected to be for a contract term of two years, with an optional two (2) year renewal option, if in the best interest of the state, and subject to Board of Examiners approval.

AGENCY BACKGROUND

Managed care was implemented in Nevada in 1997. With Medicaid expansion in 2014, the program grew from a small portion of the overall medical assistance program to the predominant service delivery model in the state, with 75% of the state’s Medicaid population enrolled in a managed care plan. Additionally, the program grew in terms of the number of plans with which it contracts. While not all Medicaid-eligible individuals are required to obtain their health coverage from a managed care entity, at the present time, approximately 683,801 Nevadans are enrolled in a managed care plan. In the four years of the current contract period, the federal regulatory framework that governs Medicaid managed care has changed significantly. At this juncture the Department of Health and Human Services is eager to improve the use of managed care to positively impact the health of the Nevadan’s that are served by the program and, in doing so improve health care in Nevada. During the 82nd legislative session, DHCFP received state approval in its budget to finance the expansion of the Medicaid Managed Care Program to all counties in the State pursuant to Nevada Revised Statute §422.273. This expansion will begin on January 1, 2026, with the procurement and implementation of the next Managed Care Contract Period, resulting in approximately a ten percent increase in the percentage of Medicaid members served by the State’s Medicaid Managed Care Program.

SCOPE OF WORK

Vendor shall provide in detail how Nevada can leverage its Medicaid Managed Care Organization (MCO) procurement to achieve the following goals within each section of this RFP’s Scope of Work. Vendors shall:

Ensure upcoming procurement contract language supports best practices in MCO accountability and performance expectations.

Ensure that the resulting contract encourages improvements in the health status of the member populations, with particular focus on the DHCFP’s Strategic Plan.

These goals that are applicable to the managed care program have been defined as:

Promoting health coverage for all Nevadans;

Increasing access to and use of primary care and preventative services;

Improving the quality of and access to behavioral health services available to members;

Ensuring all pregnant women, children and parents have the support they need.

The following programs may be included:

Supporting healthy aging for Nevadans; and Developing a comprehensive strategy for prescription drug coverage and pricing.

Vendor shall attend agency directed meetings to ensure the feedback from Nevada stakeholders is included in the development of the contract to maximize the benefits of managed care to Nevada’s communities and mitigate any negative impacts to the capacity of the healthcare system. DHCFP shall work with the Vendor and the workshop/listening sessions schedule once determined.

Ensure that the upcoming procurement results in contracts that DHCFP can effectively and efficiently oversee for compliance and quality performance.

MCO RFP ACTIVITIES - Vendor shall provide the following services in the development of the new MCO RFP:

Work with DHCFP Staff to articulate goals and priorities for procurement process in a manner that is understandable to the community of stakeholders. Develop presentations for use by DHCFP at public sessions to discuss the managed care program and intended revisions of the RFP.

Work with DHCP staff to develop RFPs and draft model contract for the procurement of Nevada’s managed care organizations. Review the current contract and the draft language the staff have developed for considerations of changes that would move Nevada toward national best practices, including model contracts, and assessing the draft contract. Training and consultation with DHCFP staff to ensure understanding of the oversight implications of the RFP including recommendations for contracts.

Review national best practices for Medicaid Managed Care with DHCFP and Department staff, including staff from other Divisions and staff responsible for developing policy within DHCFP.

Review draft contract for compliance with the Medicaid Managed Care final regulations as outlined in 42 Code of Federal Regulations 438 Managed Care, as well as the State Guide to CMS Criteria for Medicaid Managed Care Contract Review and Approval with DHCFP Staff and determine mechanisms that the DHCFP will use to monitor vendor compliance throughout the contract period. Evaluate State’s managed care oversight processes and make recommendations to strengthen monitoring and oversight of the managed care plans. Provide training to DHCFP staff on such monitoring. Assist DHCFP staff in the development of processes and tools for such monitoring.

Work with the DHCFP Administration on the development of a scoring/criteria tool for use by the evaluation committee that supports the priorities identified by the state following NRS 333 guidelines. Provide technical assistance related to the bidding and scoring process, including assistance in responding to bidder questions and assistance in developing evaluation scoring criteria.

Develop and provide training to the evaluation committee to ensure the understanding of the criteria and process.

Provide consultation during the negotiation phase of the RFP to ensure that contract meets CMS and any other applicable requirements to ensure Nevada’s goals are met within a timely manner.

Provide ongoing project management and support throughout the engagement, ensuring RFP deliverables and timeframes are met, provide communication to staff and stakeholders regarding the process, reporting on milestones and deliverables that can be used by Division and Department staff to monitor and communicate progress of the project.

Provide ongoing tracking of changes to the scope of work, as well as design decisions for areas outside the scope of work to help organize and describe submission requirements, score, and results.

STAFFING REQUIREMENTS - Vendors must demonstrate experience, knowledge and/or expertise, in the following areas.

Vendor shall provide sufficient qualified staff with programmatic and legal subject matter expertise to perform the contracted services to the DHCFP’s satisfaction. This shall include staff, with recent experience assisting a state that has a mature managed care program with its managed care procurement, program design and contracting process; the Vendor shall provide recommendations on best practices, overall planning, support and guidance, as well as project management support.

Vendor shall provide a timeline for each component of the scope of work; including staff hours for personnel involved. The Vendor shall identify the tasks to be performed, designate the staff that will perform the tasks, and outline how the staff will be managed. The timeline submitted must coincide with Nevada’s overall managed care procurement timeline under Section 3.3.12 Upon request, staff shall be required to perform contracted services in-person. DHCFP will be responsible for providing reasonable notice, seven (7) calendar days, and identify the date, time, and location for which in-person services are required.

Vendor may, with DHCFP approval, provide services remotely, using electronic means of communication, including e-mail, telephone, and through web-conferencing or other video communication acceptable to both parties.

Respected national track record on RFP and model contract development for Medicaid Managed Care delivery systems and optimizing managed care health plan performance.

Understanding Medicaid Managed Care procurement processes in other states.

Exceptional written and verbal communication skills with project management depth related to healthcare delivery systems and procurement processes.

Staff with experience working for a state agency with an established managed care program, as well as staff that has worked health care systems or health plans.

Vendors shall provide the following information as part of the RFP process:

Why are you as a vendor uniquely qualified to assist Nevada with its re-procurement RFP development, and in what states have you successfully undertaken the re-procurement efforts that have brought highly skilled carriers to the procurement process?

Provide three (3) detailed examples of experience relative to Medicaid Managed Care procurements.

Provide a written work plan describing the process and timeline for the activities outlined within this RFP.

Describe your recommended approach and plan for supporting the re-procurement effort.

Vendors shall provide a timeline for each component of the scope of work; including staff hours for personnel involved. Identify the tasks to be performed, designate the staff that will perform the tasks, and outline how the staff will be managed. The timeline submitted must coincide with Nevada’s overall managed care procurement timeline below in Section 3.3.12.

Vendor may, with DHCFP approval, provide services remotely, using electronic means of communication, including e-mail, telephone, and through web-conferencing or other video communication acceptable to both parties.

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Nevada’s estimated timeline for the Managed Care Procurement is outlined below and subject to change.

MCO CY 2026

COST

Deliverables for this project will be based on the submitted work plan, associated timeline. The timeline must incorporate each component of the scope of work and include staff hours and personnel involved. Refer to Attachment Cost Schedule within NevadaEPro for cost instructions and submittal. Costs not submitted on the State provided worksheet may render a vendor’s entire proposal nonresponsive.

ATTACHMENTS

ATTACHMENTS INCORPORATED BY REFERENCE. To be read and not returned.

Terms and Conditions for Services Terms and Conditions for Goods Business Associate Addendum

ATTACHMENTS FOR REVIEW. To be read and not returned (unless redlining).

Contract Form Insurance Schedule

PROPOSAL ATTACHMENTS. To be completed and returned.

Cost Schedule Proposed Staff Resume Reference Questionnaire Attachments for Signature

Vendor Information Response Vendor Certifications Certification Regarding Lobbying Confidentiality and Certification of Indemnification

TIMELINE

QUESTIONS. All questions regarding this solicitation shall be submitted using the Bid Q&A feature in NevadaEPro.

TIMELINE. The following represents the proposed timeline for this project.

All times stated are Pacific Time (PT).

These dates represent a tentative schedule of events.

The State reserves the right to modify these dates at any time.

EVALUATION

Evaluation and scoring are conducted in accordance with NRS 333.335 and NAC 333.160-333.165.

Proposals shall be kept confidential until a contract is awarded.

In the event the solicitation is withdrawn prior to award, proposals remain confidential.

The evaluation committee is an independent committee established to evaluate and score proposals submitted in response to the solicitation.

Financial stability shall be scored on a pass/fail basis.

Proposals shall be consistently evaluated and scored based upon the following factors and relative weights.

Cost proposals will be evaluated based on the following formula.

Cost Factor Weight x (Lowest Cost Submitted by a Vendor / Proposer Total Cost) = Cost Score

MANDATORY MINIMUM REQUIREMENTS

Pursuant to NRS 333.311 a contact cannot be awarded to a proposal that does not comply with the requirements listed in this section. Proposal shall include confirmation of compliance with all mandatory minimum requirements.

NEVADA LAW AND STATE INDEMNITY. Pursuant to NRS 333.339, any contract that is entered into may not: (1) Require the filing of any action or the arbitration of any dispute that arises from the contract to be instituted or heard in another state or nation; or (2) Require the State to indemnify another party against liability for damages.

NO BOYCOTT OF ISRAEL. Pursuant to NRS 333.338, the State of Nevada cannot enter a contract with a company unless that company agrees for the duration of the contract not to engage in a boycott of Israel. By submitting a proposal or bid, vendor agrees that if it is awarded a contract, it will not engage in a boycott of Israel as defined in NRS 333.338(3)(a).

INDEMNIFICATION. Required contract terms on Indemnification: "To the fullest extent permitted by law, Contractor shall indemnify, hold harmless and defend, not excluding the State’s right to participate, the State from and against all liability, claims, actions, damages, losses, and expenses, including, without limitation, reasonable attorneys’ fees and costs, arising out of any breach of the obligations of Contractor under this contract, or any alleged negligent or willful acts or omissions of Contractor, its officers, employees and agents. Contractor’s obligation to indemnify the State shall apply in all cases except for claims arising solely from the State’s own negligence or willful misconduct. Contractor waives any rights of subrogation against the State. Contractor’s duty to defend begins when the State requests defense of any claim arising from this Contract."

LIMITED LIABILITY. Required contract terms on Limited Liability: "The State will not waive and intends to assert available NRS Chapter 41 liability limitations in all cases. Contract liability of both parties shall not be subject to punitive damages. Damages for any State breach shall never exceed the amount of funds appropriated for payment under this Contract, but not yet paid to Contractor, for the Fiscal Year budget in existence at the time of the breach. Contractor’s tort liability shall not be limited."

CONTRACT RESPONSIBILITY. Awarded vendor shall be the sole point of contract responsibility. The State shall look solely to the awarded vendor for the performance of all contractual obligations which may result from an award based on this solicitation, and the awarded vendor shall not be relieved for the non-performance of any or all subcontractors.

DATA ENCRYPTION. State IT requires that data be encrypted in transit and in rest.

STATESIDE DATA. State IT requires that State data assets must be maintained in the United States and data will not be held offshore.

NEVADA BUSINESS LICENSE. Pursuant to NRS 353.007, prior to contract execution awarded vendor must hold a state business license pursuant to NRS chapter 76 unless exempted by NRS 76.100(7)(b).

DISCLOSURE. Each vendor shall include in its proposal a complete disclosure of any alleged significant prior or ongoing contract failures, contract breaches, any civil or criminal litigation or investigations pending which involves the vendor or in which the vendor has been judged guilty or liable.

CRITICAL ITEMS

In addition to the Scope of Work and Attachments, the items listed in this section are critical to the success of the project. These items will be used in evaluating and scoring the proposal. Vendor proposal should address items in this section in enough detail to provide evaluators an accurate understanding of vendor capabilities. Proposals that fail to sufficiently respond to these items may be considered non-responsive.

CONTRACT FORM. The State strongly prefers vendors agree to the terms of the attached Contract Form as is. Ability to agree to contract terms is a high priority to the State. Vendors who cannot agree to the contract as is must include a redlined Word version of the attached Contract Form with their proposal response. To the extent a vendor has prior contractual dealings with the State, no assumption should be made that terms outside those provided herein have any influence on this project.

INSURANCE SCHEDULE

The State strongly prefers vendors agree to the terms of the attached Insurance Schedule as is. Vendors who cannot agree must explain which areas are causing non-compliance and attach a red line if necessary.

Awarded vendor shall maintain, for the duration of the contract, insurance coverages as set forth in the fully executed contract.

Work on the contract shall not begin until after the awarded vendor has submitted acceptable evidence of the required insurance coverages.

Failure to maintain any required insurance coverage or acceptable alternative method of insurance shall be deemed a breach of contract.

VENDOR BACKGROUND

Company background/history and why vendor is qualified to provide the services described in this solicitation.

Provide a brief description of the length of time vendor has been providing services described in this solicitation to the public and/or private sector.

VENDOR STAFF RESUMES

A resume shall be included for each proposed key personnel, see Proposed Staff Resume.

A resume shall also be included for any proposed key subcontractor personnel.

SUBCONTRACTORS

Subcontractors are defined as a third party, not directly employed by the contractor, who shall provide services identified in this solicitation. This does not include third parties who provide support or incidental services to the contractor.

Proposal should include a completed Vendor Information Response form for each subcontractor.

Vendor shall not allow any subcontractor to commence work until all insurance required of the subcontractor is provided to the vendor.

Vendor proposal shall identify specific requirements of the project for which each subcontractor shall perform services.

How the work of any subcontractor(s) shall be supervised How channels of communication shall be maintained How compliance with contracts terms and conditions will be assured Previous experience with subcontractor(s)

VENDOR FINANCIAL INFORMATION

The information requested in this section is designated as confidential business information by the Administrator pursuant to NRS 333.020(5)(b) and is not public information pursuant to NRS 333.333.

This information should be submitted as a separate attachment, flagged as confidential in NevadaEPro.

Proposing vendor shall provide the following financial information and documentation:

Dun and Bradstreet Number Federal Tax Identification Number The last two (2) full years and current year interim:

1. Profit and Loss Statements

2. Balance Statements

BUSINESS REFERENCES

The information requested in this section is designated as confidential business information by the Administrator pursuant to NRS 333.020(5)(b) and is not public information pursuant to NRS 333.333.

Vendors shall provide a minimum of three (3) business references from similar projects performed for private and/or public sector clients within the last five (5) years, see Reference Questionnaire.

The purpose of these references is to document relevant experience and aid in the evaluation process.

Business references should return Reference Questionnaire directly to Single Point of Contact via email.

Business references will not be accepted directly from proposing vendor.

Business references shall not be requested from the soliciting agency.

The State will not disclose submitted references, but will confirm if a reference has been received.

The State reserves the right to contact references during evaluation.

SUBMISSION CHECKLIST

This section identifies documents that shall be submitted to be considered responsive. Vendors are encouraged to review all requirements to ensure all requested information is included in their response.

Proposals must be submitted as a Quote through NevadaEPro, https://NevadaEPro.com.

Vendors are encouraged to submit a single file attachment per proposal section if possible.

Technical proposal information and Cost proposal information shall not be included in the same attachment.

Cost proposal attachment shall not be flagged as confidential in NevadaEPro.

Additional attachments may be included, but are discouraged and should be kept to a minimum.

TECHNICAL PROPOSAL

Title Page Table of Contents Response to Mandatory Minimum Requirements Response to Critical Items Response to Scope of Work Proposed Staff Resumes Other Informational Material

PROPRIETARY INFORMATION. If necessary. Attachment should be flagged confidential in NevadaEPro.

Title Page Table of Contents Trade Secret information, cross referenced to the technical proposal

COST PROPOSAL

VENDOR FINANCIAL INFORMATION. Attachment should be flagged confidential in NevadaEPro.

SIGNED ATTACHMENTS

Vendor Information Response Vendor Certifications Confidentiality and Certification of Indemnification Certification Regarding Lobbying

OTHER ATTACHMENTS. If necessary, not recommended.

REFERENCE QUESTIONNAIRES. Not submitted directly by vendor.

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