RFQ 2023-08 NCQA Accreditation Services - Draft FINAL 5-17-2023.pdf

RFQ 2023-08 NCQA Accreditation Services Page 1

REQUEST FOR QUOTES (RFQ) #2023-08

NCQA Accreditation Services

Issue Date: May 17, 2023

Project Name: RFQ 2023-08 NCQA Accreditation Services Quote Due Date/Time: June 14, 2023, 2:00 PM Pacific Time Procurement Representative: Lee Reinholtz, OPBC Phone: 503-416-1797 Email: reinholtzl@careoregon.org

SUBMIT QUOTES VIA EMAIL TO PROCUREMENT@CAREOREGON.ORG

PLEASE NOTE: EMAIL SUBMISSIONS SHOULD HAVE “RFQ 2023-08 NCQA

ACCREDITATION SERVICES” IN THE SUBJECT LINE

1. ANNOUNCEMENT AND SPECIAL INFORMATION

Quoters are required to read, understand, and comply with all information contained within this Request for Quotes (“RFQ”). All quotes are binding upon Quoter for sixty (60) days from the Quote Due Date/Time. Quotes received after the Quote Due Date/Time may not be considered. If authorized in the RFQ and resulting contract, travel and other expense reimbursement will only be reimbursed in accordance with the CareOregon Travel Reimbursement Allowance in effect at the time the expense is incurred. The Policy may be found at https://www.careoregon.org/contact-us/vendor-resources.

RFQ Documents can be downloaded from OregonBuys at the following address:

https://oregonbuys.gov/bso/. Prospective Quoters will need to sign in to download the information and that information will be accumulated for a Plan Holder's List. Prospective Quoters are responsible for obtaining any addenda or clarifying questions from OregonBuys.

Complete Quotes must be emailed to Procurement@careoregon.org. The subject line of the email must identify the RFQ title. Quoters are encouraged to contact Procurement to confirm receipt of the Quote.

CareOregon evaluators may recommend an award based solely on the written responses or may request Quoter interviews/presentations. Interviews shall take place virtually and tentatively scheduled between June 21 – 23rd, 2023. The invited Quoters will be notified of the time and format of the interview/presentation. Interviews will be conducted via MS Teams and during Pacific Time business hours.

All questions regarding this RFQ are to be directed to the Procurement Representative named above. Deadline for clarifying questions related to this solicitation is due no later than June 5, 2023, 5:00 pm PT. Quoters may not communicate with CareOregon employees or representatives about the RFQ during the procurement process until the Procurement Department has notified Quoters of the selected Quoter. Communication in violation of this restriction may result in rejection of a Quoter.

BACKGROUND

CareOregon is seeking a contractor with deep expertise in National Committee for Quality Assurance (“NCQA”) accreditation to lead the organization through the accreditation process. CareOregon is pursuing NCQA Accreditation to showcase our organization’s commitment to quality. Pursuing

CareOregon, Inc.

Procurement Department

315 SW 5th Ave.

Portland, OR 97204

(503) 416-7646 (Office) mailto:Procurement@careoregon.org https://www.careoregon.org/contact-us/vendor-resources https://www.careoregon.org/contact-us/vendor-resources https://oregonbuys.gov/bso/ mailto:Procurement@careoregon.org

RFQ 2023-08 NCQA Accreditation Services Page 2

NCQA accreditation will provide a framework for performing gap analysis, aligning improvement activities, improving operational efficiency, and satisfying state and federal guidelines around quality.

CareOregon will provide strategic direction, decision making, and will fulfill advisory roles.

CareOregon is seeking a contractor with sufficient capacity to deliver and fulfill the production needs at each stage of this project. The contractor will have the ability to quickly assess organizational gaps in accreditation requirements, help develop and improve documents and processes, prepare the applications, and provide subject matter expertise along the way. We are seeking support in the form of both advisement as well as document preparation and completion. We have a team that will help facilitate meetings, provide access to background documents and information, coordinate within CareOregon, and help coordinate deliverables with the contractor.

We are currently working on preparation of the NCQA Health Equity Plus Accreditation application and intend to submit by December 2023. Our goal is to submit for full Health Plan Accreditation by December 2024. We are looking for a consultant with experience achieving NCQA Health Equity, Health Equity Plus, or Multicultural Distinction Accreditation in addition to expert guidance on NCQA Health Plan Accreditation processes.

2. SCOPE

CareOregon seeks comprehensive consulting services for NCQA Health Plan Accreditation & Health Equity Plus Accreditation. This consulting project involves leading and implementing the CareOregon NCQA Health Equity Plus Accreditation process in 2023 and the NCQA Health Plan Accreditation process in 2023-2024. These services will be provided to CareOregon virtually.

This project includes full-service NCQA accreditation process consulting, gap analysis, policy document development, timeline management, recommendations, survey preparation, application preparation, and training staff to maintain operations of accreditation going forward.

SERVICES

A. Research and create a comprehensive workplan specific to CareOregon that outlines a detailed schedule of tasks, milestones, deliverables, responsible parties, and estimated completion dates, inclusive of regular cadence of consultive meetings with CareOregon contract administrator and advisory team.

B. Create a Readiness Assessment (gap analysis) for NCQA Health Plan Accreditation and Health Equity Plus Accreditation to include:

i. Review all areas required for full compliance with NCQA Health Plan Accreditation and Health Equity Plus Accreditation.

ii. Provide scoring and feedback, highlighting areas of concern.

C. Create an Improvement Plan to include:

i. Recommend changes for all areas of concern and areas that are not in full compliance with NCQA Health Plan Accreditation and Health Equity Plus Accreditation standards that facilitates compliance with the identified standard.

ii. Identify time needed to come into compliance including lookback periods.

iii. Identify upcoming changes to NCQA standards and any needed changes to come into compliance.

D. Perform additional review of criterion determined not to be in full compliance, including evidence associated with determining compliance and efforts made to come into full compliance.

E. Create a timeline to come into full compliance (including lookback periods).

F. Communicate with CareOregon project team and executive leaders about expectations for achieving accreditation in the expected timeline.

G. Provide technical assistance to achieve full compliance.

H. Draft documentation describing a path to full compliance.

I. Train staff on those standards that are not in full compliance.

J. Provide technical assistance with document development including drafting language in existing and new documents to achieve full compliance.

K. Provide technical assistance with the accreditation submissions.

L. Provide technical assistance with preparation for NCQA review.

RFQ 2023-08 NCQA Accreditation Services Page 3

M. Train staff to maintain operations of accreditation going forward to prepare for reaccreditation.

N. Perform other consultation regarding full compliance with NCQA Health Plan Accreditation and

Health Equity Plus Accreditation, as requested by CareOregon.

O. Attend once weekly progress meetings with CareOregon contract administrator.

DELIVERABLES

A. Comprehensive work plan to achieve the accreditations. Workplan to be updated regularly to track progress to timeline.

B. Deliver Readiness Assessment (gap analysis) for NCQA Health Plan Accreditation and Health

Equity Plus Accreditation.

C. Deliver Improvement Plan to bring CareOregon into compliance for NCQA Health Plan

Accreditation and Health Equity Plus Accreditation.

D. Deliver documents and technical assistance needed to come into compliance with NCQA Health

Plan Accreditation and Health Equity Plus Accreditation, including policy documents.

E. Deliver collateral materials to include cataloguing, reference materials, progress reports, and outcome reports.

F. Deliver operations and logistics manuals enabling CareOregon to maintain accreditation going forward.

G. Provide trainings to staff members on how to interact with and navigate NCQA Health Plan

Accreditation and Health Equity Plus Accreditation.

MILESTONES/TIMELINE:

Q3 2023: Readiness Assessment (gap analysis) completed.

Q3 2023: Deliver written improvement approach for Health Equity Plus Accreditation and address Health Equity gaps.

Q4 2023: Provide expert assistance in Health Equity Plus Accreditation Survey (Health Equity

Plus application is already submitted for Q4 2023 survey date).

Q4 2023: Deliver written improvement approach for Health Plan Accreditation.

Q4 2023 - Q1 2024: Align CareOregon with NCQA Health Plan requirements, address all gaps.

Verify all CareOregon policies & procedures are written to standard, and in full alignment with NCQA requirements. Submit pre-application for a Q4 Health Plan Survey.

Q2-Q3 2024: 6-month lookback period for Health Plan Accreditation.

Q3 2024: Prepare staff for Health Plan Accreditation Survey.

Q4 2024: Provide support to CareOregon through Survey and File Review.

Q1 2025: Perform operational training and transition.

Q2 2025: Project closeout.

TERM OF CONTRACT The initial term is twenty-four (24) months with the option for two (2) contract extensions, for six (6) months each.

PERFORMANCE REQUIREMENTS

Review milestones and timeline for proper adherence at each meeting with CareOregon contract administrator. Make corrections as necessary to maintain the project timeline. Performance requirements and conditions will be addressed at the contracting stage in the Scope of Work.

3. SAMPLE CONTRACT

Submission of a Quote in response to this RFQ indicates Quoter’s willingness to enter into a contract containing substantially the same terms of the below referenced contract, which can be found at:

https://careoregon.org/contact-us/vendor-resources, with the requirements indicated below. No action or response to the sample contract is required under this RFQ. The applicable sample contract is the:

Professional Services Contract (unless checked, item does not apply) https://careoregon.org/contact-us/vendor-resources

RFQ 2023-08 NCQA Accreditation Services Page 4

The following paragraphs of the Professional Services Contract will be applicable:

Article I, Paragraph 5 – Travel and Other Expense is Authorized Article II, Paragraph 29 – Protection of Patient Privacy and Security Article II, Paragraph 30 – Criminal Background Check Requirements Article II, Paragraph 31 – Key Persons Article II, Paragraph 32 – On-Call Contract Basis Article II, Paragraph 33 – CareOregon Data Security Requirements

The following insurance requirements will be applicable:

Commercial General Liability: combined single limit, or the equivalent, of not less than $1,000,000 per occurrence, with an annual aggregate limit of $2,000,000 for Bodily Injury and Property Damage.

Professional Liability: combined single limit, or the equivalent, of not less than $1,000,000 per occurrence, with an annual aggregate limit of $2,000,000 for damages caused by error, omission, or negligent acts.

Automobile Liability: combined single limit, or the equivalent, of not less than $500,000 per occurrence for Bodily Injury and Property Damage.

Cyber Liability: combined single limit, or the equivalent, of not less than $1,000,000 per occurrence for network security (including data breach), privacy, interruption of business, media liability, and errors and omissions.

4. QUOTE

Quotes should be short and concise, no more than 20 pages, with the following information:

A. Provide a detailed approach to assessment, expected data needs along with file specifications.

B. Company experience assisting organizations in securing NCQA accreditation.

C. Company experience assisting organizations in securing NCQA Health Equity, Health

Equity Plus, and/or Multicultural Health Care Distinction.

D. Experience of staff that will work on the project.

E. Describe your approach to production support for gaps identified during a Readiness

Assessment, e.g., policy development, standard operating procedures, data sets, workflows.

F. Provide a high-level project workplan that outlines project approach, milestones, and timelines.

G. Provide fees on a time and materials basis with a not-to-exceed price to complete the project.

H. Company values and moral fitness:

a. Describe how your organization supports diversity, equity, and inclusion.

b. Identify any issues or concerns in social media about your firm.

c. Describe if your firm is currently or potentially engaged in litigation?

d. Provide information demonstrating that your firm is financially stable.

I. Provide at least three references from clients for similar projects (Other than CareOregon Staff).

J. Quote Certification Form Signed (see next page). Must be included with your Quote.

K. Any additional information that CareOregon should take into consideration for the project or qualifications.

5. EVALUATION

Quotes will be evaluated based on subjective factors including, but not limited to: Firm experience, staff experience, price/fees, references, and proposal to complete the project (including applicable timelines).

RFQ 2023-08 NCQA Accreditation Services Page 5

QUOTE CERTIFICATION FORM

RFQ #2023-08

Submitted by:

(Must be entity’s full legal name, and State of Formation)

Each Quoter must read, complete, and submit a copy of this Quote Certification with their Quote. Failure to do so may result in rejection of the Quote. By signature on this Quote Certification, the undersigned certifies that they are authorized to act on behalf of the Quoter and that under penalty of perjury, the undersigned will comply with the following:

SECTION I. NON-DISCRIMINATION: That the Quoter has not and will not discriminate in its employment practices with regard to race, color, creed, age, religious affiliation, sex, marital status, disability, sexual orientation, gender identity, national origin, veteran status, or any other protected class. Nor has Quoter or will Quoter discriminate against a subcontractor in the awarding of a subcontract because the subcontractor is a disadvantaged business enterprise, a minority-owned business, a woman-owned business, a business that a service-disabled veteran owns or an emerging small business that is certified under ORS 200.055.

SECTION II. CONFLICT OF INTEREST: The undersigned hereby certifies that no officer, agent or employee of CareOregon is personally interested, directly or indirectly, in any resulting contract from this RFQ, or the compensation to be paid under such contract, and that no representation, statements (oral or in writing), of the CareOregon, its officers, agents, or employees had induced Quoter to submit this Quote. In addition, the undersigned hereby certifies that this proposal is made without connection with any person, firm, or corporation submitting a proposal for the same material, and is in all respects fair and without collusion or fraud.

SECTION III. COMPLIANCE WITH SOLICITATION: The undersigned further agrees and certifies that they:

1. Have read, understand, and agree to be bound by and comply with all requirements, instructions, specifications, terms, and conditions of the RFQ (including any attachments); and

2. Are an authorized representative of the Quoter, that the information provided is true and accurate, and that providing incorrect or incomplete information may be cause for rejection of the Quote or contract termination; and

3. Will furnish the designated item(s) and/or service(s) in accordance with the RFQ and Quote.

Name:_________________________________________ Date:__________________________________________

Signature:______________________________________ Title:__________________________________________

Email:_________________________________________ Phone:_________________________________________

Oregon Business Registry Number:__________________ OR CCB # (if applicable):____________________________

Quoter Primary Point of Contact (Coordination during process and for award information):

Name:_______________________________________

Email:_______________________________________ Phone:_____________________________________

Business Designation (check one):

Corporation Partnership Sole Proprietorship Non-Profit Limited Liability Company

Minority (MBE), Women (WBE), Service-Disabled Veteran (SDV), and Emerging Small Business (ESB):

Certified by the State of Oregon (provide certification number as applicable):

MBE WBE SDV ESB

Self-identified (check as applicable):

MBE WBE SDV ESB

RFQ 2023-08 NCQA Accreditation Services Page 6

CAREOREGON, INC.

INSTRUCTIONS TO QUOTERS

1. QUOTE FORMAT: Quotes must be submitted as indicated in the RFQ.

2. CONFORMANCE TO RFQ REQUIREMENTS: Quotes must conform to the requirements of the RFQ. Unless otherwise specified, all items quoted are to be new, unused, and not remanufactured in any way. Any requested attachments must be submitted with the quote and in the required format. Quote prices must be for the unit indicated on the quote. Failure to comply with all requirements may result in quote rejection.

3. ADDENDA: Only documents issued as addenda by CareOregon serve to change the RFQ in any way. No other directions received by the Quoter, written or verbal, serve to change the RFQ document. NOTE: IF YOU HAVE RECEIVED A COPY OF THE RFQ, YOU SHOULD CONSULT OREGONBUYS (https://oregonbuys.gov/bso/) TO

ENSURE THAT YOU HAVE NOT MISSED ANY ADDENDA OR ANNOUNCEMENTS. QUOTERS ARE NOT

REQUIRED TO RETURN ADDENDUMS WITH THEIR QUOTE. HOWEVER, QUOTERS ARE RESPONSIBLE

TO MAKE THEMSELVES AWARE OF, OBTAIN AND INCORPORATE ANY CHANGES MADE IN ANY

ADDENDA ISSUED INTO THEIR FINAL QUOTE. FAILURE TO DO SO MAY, IN EFFECT, MAKE THE

QUOTER'S QUOTE NON-RESPONSIVE, WHICH MAY CAUSE THE QUOTE TO BE REJECTED.

4. USE of BRAND or TRADE NAMES: Any brand or trade names used by CareOregon in the specifications are for the purpose of describing and establishing the standard of quality, performance, and characteristics desired and are not intended to limit or restrict competition. Quoters may submit quotes for substantially equivalent products to those designated unless the RFQ provides that a specific brand is necessary because of compatibility requirements, etc. All such brand substitutions shall be subject to approval by CareOregon.

5. PRODUCT IDENTIFICATION: Quoters must clearly identify all products quoted. Brand name and model or number must be shown. CareOregon reserves the right to reject any quote when the product information submitted with the quote is incomplete.

6. FOB DESTINATION: Unless specifically allowed in the RFQ, QUOTE PRICE MUST BE F.O.B. DESTINATION with all transportation and handling charges included in the Quote.

7. DELIVERY: Delivery time must be shown in number of calendar days after receipt of purchase order.

8. EXCEPTIONS: Any deviation from quote specifications, or the form of sample contract referenced in this RFQ, may result in quote rejection at CareOregon’s sole discretion.

9. SIGNATURE ON QUOTE: Quotes must be signed by an authorized representative of the Quoter. Signature on a quote certifies that the quote is made without connection with any person, firm or corporation making a quote for the same goods and/or services and is in all respects fair and without collusion or fraud. Signature on a quote also certifies that the Quoter has read and fully understands all quote specifications, and the sample contract referenced in this RFQ (including insurance requirements). No consideration will be given to any claim resulting from quoting without comprehending all requirements of the RFQ.

10. QUOTE MODIFICATION OR WITHDRAWL: Quotes, once submitted, may be modified in writing or withdrawn before the time and date set for quote closing. Quoters may not modify quotes after Quote Due Date/Time.

11. QUOTE SUBMISSION: Quotes may be submitted by returning to CareOregon by email at the email address provided in the introduction of the RFQ. The email subject line should contain the RFQ Number and RFQ Title.

12. PRIOR ACCEPTANCE OF DEFECTIVE PROPOSALS: Due to limited resources, CareOregon generally will not completely review or analyze quotes which fail to comply with the requirements of the RFQ or which clearly are not the best quotes, nor will CareOregon generally investigate the references or qualifications of those who submit such quotes.

Therefore, neither the return of a quote, nor acknowledgment that the selection is complete shall operate as a representation by CareOregon that an unsuccessful quote was complete, sufficient, or lawful in any respect.

13. DELIVERY: Significant delays in delivery may be considered in determining award if early delivery is required.

14. CASH DISCOUNTS: Cash discounts will be considered if included in the Quote.

15. PAYMENT: Quotes which require payment in less than 30 days after receipt of invoice or delivery of goods, whichever is later, may be rejected.

16. INVESTIGATION OF REFERENCES: CareOregon reserves the right to investigate references and or the past performance of any Quoter with respect to its successful performance of similar services, compliance with specifications and contractual obligations, and its lawful payment of suppliers, sub-contractors, and workers. CareOregon may postpone the award or execution of the contract after the announcement of the apparent successful Quoter in order to complete its investigation. CareOregon reserves the right to reject any quote or to reject all quotes at any time prior to CareOregon's execution of a contract if it is determined to be in the best interest of CareOregon to do so.

17. METHOD OF AWARD: CareOregon reserves the right to make the award by item, groups of items or entire quote, whichever is in the best interest of CareOregon.

18. QUOTE REJECTION: CareOregon reserves the right to reject any and all quotes.

19. QUOTE CONFIDENTIALITY AND RESULTS: Quoters who submit a quote will be notified of the RFQ results.

Quotes submitted will be considered confidential and will only be shared internally with applicable staff for this project.

Any scores or evaluation materials that CareOregon uses shall remain private and confidential information for CareOregon purposes only.

https://oregonbuys.gov/bso/