Augusta County, Virginia Request for Quotes

Date: March 25, 2026

Project Title: Pathways Program Medicaid Reimbursement Implementation (PRS Services)

RFQ #: 112201-26-01

Questions: Lacy Stajduhar, VCA

Purchasing Assistant Phone: 540-245-5741 ext. 1 Email: lstajduhar@co.augusta.va.us

Quote Deadline: 2:00 PM Friday, April 10, 2026 Please deliver to:

Lacy Stajduhar, VCA

Purchasing Assistant County of Augusta PO Box 590 Verona, VA 24482 Email: lstajduhar@co.augusta.va.us Phone: 540-245-5741 ext.1

Please provide a quote for the following:

Scope of Work: Medicaid Billing and Reimbursement Infrastructure Development

Project Title: Pathways Program Medicaid Reimbursement Implementation (PRS Services)

Project Overview

The Pathways Program seeks to engage a qualified consultant to design and implement a comprehensive Medicaid reimbursement infrastructure for certified Peer Recovery Specialist (PRS) services under the Virginia Department of Medical Assistance Services (DMAS).

This project will establish the operational, documentation, compliance, and billing systems necessary to support Medicaid-reimbursable peer services within the Pathways Program as it transitions into an affiliated 501(c)(3) entity. The work is implementation-focused and intended to result in a fully functional, audit-ready billing framework.

Scope of Services

The consultant will provide professional services including, but not limited to:

• Development of a step-by-step PRS reimbursement implementation plan

• Analysis and interpretation of DMAS requirements and applicable federal regulations mailto:lstajduhar@co.augusta.va.us

• Identification and benchmarking of comparable peer-service billing agencies

• Design of compliant documentation standards and workflows

• Development of a billing-ready documentation system aligned with DMAS requirements

• Training of peer staff on documentation and reimbursement compliance

• Trial-period documentation review and corrective feedback

• Integration of billing workflows into program operations

• Alignment of policies with HIPAA and 42 CFR Part 2 requirements

• Support for organizational alignment under the Pathways 501(c)(3) entity

• Advisory support related to governance, transparency standards (including GuideStar), and program development

• Participation in strategic planning activities, including SWOT analysis and deflection track development

• Other related duties as necessary to achieve full billing readiness

Deliverables

The consultant will produce the following deliverables:

1. Medicaid Reimbursement Implementation Plan A comprehensive, step-by-step written plan outlining all requirements and processes for PRS reimbursement under DMAS.

2. Comparable Agency Analysis A summary of similarly situated agencies utilizing Medicaid billing for peer services, including operational models and best practices.

3. Documentation Standards and Templates Standardized templates and protocols for case notes, service logs, and billing documentation compliant with DMAS requirements.

4. Workflow Integration Plan A structured workflow outlining how documentation, service delivery, and billing processes integrate within Pathways operations.

5. Training Program for Peer Staff Delivery of training sessions and materials for PRS staff on Medicaid-compliant documentation and service delivery requirements.

6. Documentation Audit and Compliance Review Review of a defined sample of participant records during a trial period, with written feedback and corrective recommendations.

7. System Recommendations Report Recommendations for the most efficient documentation and billing system, including integration with existing program tools.

8. Organizational Alignment Support Guidance and documentation to support alignment of billing operations within the Pathways 501(c)(3) structure.

9. Final Implementation Summary A summary report confirming readiness for Medicaid billing, including identified risks and recommended next steps.

Project Phases and Timeline

Phase 1: Assessment and Planning (Months 1–2)

• Regulatory analysis

• Comparable agency research

• Initial reimbursement framework

Phase 2: System Design and Development (Months 3–5)

• Documentation standards

• Workflow design

• System integration planning

Phase 3: Training and Pilot Implementation (Months 6–7)

• Staff training

• Trial documentation period

• Initial compliance review

Phase 4: Finalization and Readiness (Months 8–9)

• Documentation audit

• Final adjustments

• Implementation summary and readiness certification

Compensation and Level of Effort

• Hourly rate not to exceed $80 per hour

• Total level of effort not to exceed 530 hours

• Total compensation not to exceed $42,500

• Work will be billed based on actual hours worked, with periodic invoicing and documentation of activities

Contract Requirements

The final agreement will include:

• Defined scope of services and deliverables

• Estimated hours and compensation structure

• Timeline and milestones

• Termination provisions

• Compliance with all applicable federal, state, and local regulations

The consultant will be provided with a Pathways.org email account to ensure continuity of communications and to avoid re-registration with DMAS and related systems.

Performance Expectations

The consultant will:

• Maintain regular communication with program leadership

• Participate in scheduled meetings as needed

• Provide written updates on progress

• Deliver all materials in a format suitable for operational use and audit review

Objective

The objective of this engagement is to produce a fully functional, compliant, and sustainable Medicaid billing infrastructure that supports ongoing reimbursement for peer recovery services and strengthens the long-term viability of the Pathways Program.

REQUEST FOR QUOTATIONS

CONDITIONS AND INSTRUCTIONS

1. All informal price quotations must be submitted on and in accordance with this form. If more space is required to furnish a description of the commodities and/or services offered or delivery terms, the bidder may attach a letter hereto which will be made a part of the quotation.

2. Quotations received by the County after the date and time specified for the opening will not be considered.

It will be the responsibility of the bidder to see that his quotation is in this office by the specified time and date. There will be no exceptions. Date of postmark will not be considered. Email quotations will be accepted if received prior to stated time and date specified.

3. The time of proposed delivery must be stated in definite terms.

4. Quotations must show line items and grand total. In case of error, the grand total shall govern.

5. Unless qualified by the provision "NO SUBSTITUTION", the use of the name of a manufacturer, brand, make or catalog designation in specifying an item does not restrict bidders to the manufacturer, brand, make or catalog designation identification. This is used simply to indicate the character, quality and/or performance equivalence of the commodity desired. Any item which the County in its sole discretion determines to be the equal of that specified, considering price, quality, workmanship, economy of operation, and suitability for the purpose intended, shall be accepted. The bidder is responsible to clearly and specifically indicate the product being offered and to provide sufficient descriptive literature, and technical detail to enable the County to determine if the product offered meets the requirements of the solicitation.

6. The County reserves the right to reject any and all quotations, and to waive any informality or technical defects if, in its judgment the best interests of the County will be served.

7. All quotations must include the company name and be signed by a responsible officer or employee.

Obligations assumed by such signature must be fulfilled.

8. The successful bidder will be notified by receipt of Purchase Order.

9. Non-discrimination. During the performance of this contract, the vendor agrees as follows:

The vendor will not discriminate against any employee or applicant for employment because of race, religion, color, sex, national origin, age, disability, or any other basis prohibited by state law relating to discrimination in employment, except where there is a bona fide occupational qualification reasonably necessary to the normal operation of the vendor. The vendor agrees to post in conspicuous places, available to employees and applicants for employment, notices setting forth the provisions of this nondiscrimination clause.

The vendor, in all solicitations or advertisements for employees placed by or on behalf of the vendor, will state that such vendor is an equal opportunity employer.

Notices, advertisements and solicitations placed in accordance with federal law, rule or regulation shall be deemed sufficient for the purpose of meeting the requirements of this section.

The vendor will include the provisions of the foregoing paragraphs in every purchase order of over ten thousand dollars ($10,000), so that the provisions will be binding upon each vendor.

Where applicable, laws protecting the rights of the disabled, including the Virginians with Disabilities Act and the federal Americans with Disabilities Act, shall apply.

10. Prohibition of Alcohol and other Drugs.

(a) During the performance of this contract, the vendor agrees to (i) provide a drug-free workplace for the vendor's employees; (ii) post in conspicuous places, available to employees and applicants for employment, a statement notifying employees that the unlawful manufacture, sale, distribution, dispensation, possession, or use of a controlled substance or marijuana is prohibited in the vendor's workplace and specifying the actions that will be taken against employees for violations of such prohibition; (iii) state in all solicitations or advertisements for employees placed by or on behalf of the vendor that the vendor maintains a drug-free workplace; and (iv) include the provisions of the foregoing clauses in every purchase order of over $10,000, so that the provisions will be binding upon each vendor. For the purposes of this section, "drug-free workplace" means a site for the performance of work done in connection with a specific contract awarded to a vendor in accordance with this chapter, the employees of whom are prohibited from engaging in the unlawful manufacture, sale, distribution, dispensation, possession or use of any controlled substance or marijuana during the performance of the contract.

(b) The vendor shall also establish, maintain and enforce policies which prohibit the following acts by all vendor personnel on County premises: (1) the manufacture, distribution, dispensation, possession, or use of alcohol, marijuana or other drugs, except possession and medically prescribed use of prescription drugs; and

(2) the impairment of judgment or physical abilities due to the use of alcohol, marijuana or other drugs, including impairment from prescription drugs.

11. NONDISCRIMINATION AGAINST FAITH-BASED ORGANIZATION:

It is the policy of the County not to ( i ) discriminate against a faith-based organization on the basis of the organization’s religious character or (ii) impose conditions that (a) restrict the religious character of the faith-based organization, except for sectarian worship, instruction, or proselytizing; however, this prohibition shall not apply to expenditures pursuant to contracts, if any, for the service of chaplains, or (b) impair, diminish, or discourage the exercise of religious freedom by the recipients of such goods, services, or disbursement.

Augusta County, Virginia

Pre-Bid Question Form

Project Title: Pathways Program Medicaid Reimbursement Implementation (PRS Services)

RFQ #: 112201-26-01

The undersigned potential Bidder would like to request a written clarification, interpretation, or explanation to the following question or question(s):

Please note that all questions should be directed to the Bid Officer designated on the Request for Quote and should be received by April 6th, 2026 at 5:00 PM to allow for sufficient time for an addendum to reach all Bidders.

The County will endeavor to respond to all inquiries in the most timely manner possible. However, if in their discretion they determine the inquiry to be inappropriate for any reason, the County may refuse to respond.

Multiple inquiries of substantially the same question may be answered in one addendum.

Firm Name and Address:

____________________________________ Telephone (____) ______________

____________________________________ Fax (____) ___________________

Signature: ____________________________ Date: ________________________

Title: ________________________________ Email: _______________________

Pathways Program Medicaid Reimbursement Implementation (PRS Services)

RFQ #112101-26-01

Due Friday, April 10th, 2026 at 2:00 PM

Written Quote Amount Per Hour:

Written Numerical Quote Amount Per Hour: $

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