RHT27.pdf

REQUEST FOR QUOTATION

ARFQ RHT27*01

Rural Health Link: Unified Health-Mobility Platform

Revised 10/27/2014

SPECIFICATIONS

1. PURPOSE AND SCOPE: The West Virginia Office of Shared Administration (OSA) Office of Purchasing is soliciting bids on behalf of the Department of Health’s Rural Health Transformation Program (hereinafter referred to as “RHTP”) to establish an open-end contract for the design, development, deployment, and hosting of the Rural Health Link Unified Health-Mobility Platform (the "Platform"). The Platform is a statewide technology solution connecting patients, providers, non-emergency medical services, and other transportation resources to ensure rural West Virginia residents can reliably access healthcare. This procurement is strictly for a technology development partner. This contract is distinct and separate from any future or concurrent operational contracts for transportation services or fleet brokerage. Bidders must focus exclusively on delivering a production-ready technology platform. Proposals that fail to meet any individual mandatory requirement will be disqualified. The contract will be awarded to the responsive and responsible bidder that meets all mandatory requirements and submits the lowest overall total cost.

The State of West Virginia (the State) has been awarded approximately $200 million through the Rural Health Transformation Program (RHTP), established under Section 71401 of Public Law 119-21, the One Big Beautiful Bill Act, signed into law by President Trump on July 4, 2025.

These funds, which flow down from the Centers for Medicare and Medicaid Services (CMS), will be used to reduce chronic disease burden, increase workforce participation, and improve measurable outcomes in our rural communities by increasing healthcare technology to ultimately improve both quality and access to healthcare. Furthermore, this initiative supports Health and Human Services Secretary Robert F. Kennedy Jr.'s “Making America Healthy Again” and Governor Morrisey’s “Four Pillars of a Healthy West Virginia” goals by focusing on nutrition, wellness, and local food sources. The West Virginia RHTP consists of seven initiatives: Connected Care Grid, Rural Health Link, Mountain State Care Force, Smart Care Catalyst, Health to Prosperity, Personal Health Accelerator, and HealthTech Appalachia.

This is not a planning or pilot effort. The Platform must be fully operational, integrated, and actively usable within 12 months of contract execution.

Rural Health Link: Unified Health-Mobility Platform

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Please note that the WV RHTP is supported by CMS, an agency of the U.S. Department of Health and Human Services (HHS) as part of an initial financial assistance award totaling $199,476,098.72 with 100% of the award funded by CMS/HHS. The contents of this RFQ are prepared by the State and do not necessarily represent the official views of, or an endorsement by, CMS/HHS or any other agency of the United States Government.

2. DEFINITIONS: The terms listed below shall have the meanings assigned to them below. Additional definitions can be found in section 2 of the General Terms and Conditions.

2.1 "Agency" means the WV RHTP, acting through the West Virginia Department of Health.

2.2 "API" means Application Programming Interface.

2.3 "Contract Items" means the Platform and all associated deliverables identified in Section 3 and the Pricing Pages.

2.4 "Data Spine" means the West Virginia Data Spine, a statewide health data infrastructure currently under development.

2.5 "Explanation of Payment (EOP)" means a report generated by the Platform detailing trip-level payment calculations, adjudication status, and any denial reasons, accessible to Operators and Subcontractors through their portal accounts.

2.6 "FHIR" means Fast Healthcare Interoperability Resources, the current federal standard for healthcare data exchange.

2.7 "FHIR R4" means Version R4 of the FHIR standard.

2.8 "EHR" means Electronic Health Record.

2.9 "HIPAA" means Health Insurance Portability and Accountability Act.

2.10 "HL7" means Health Level Seven.

2.11 "HL7 v2" means Version 2 of HL7's messaging standard.

2.12 "Managed Services" means ongoing platform maintenance, security patching, updates, and technical support provided by Vendor.

2.13 "Member Portal" means the self-service interface through which members may schedule, manage, and track transportation requests. The Member Portal may be delivered as a web-based application, a mobile application, or both, at the Vendor's discretion subject to Agency approval.

2.14 "MMIS" means Medicaid Management Information System.

2.15 "MMIS Administrator" means the entity contracted by the State of West

Virginia to administer the Medicaid Management Information System, currently Gainwell Technologies. References to MMIS Administrator throughout this Solicitation shall apply to whatever entity holds that role at the time of integration.

2.16 "NEMT" means Non-Emergency Medical Transportation.

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2.17 "NIST" means the National Institute of Standards and Technology.

2.18 "Operator" means a third-party entity that contracts with the Agency and/or the West Virginia Bureau for Medical Services to provide transportation coordination services using the Platform. An Operator may deliver services through a network of Subcontractors rather than directly employing drivers or operating vehicles.

2.19 "PHI" means Protected Health Information as defined under HIPAA, including 45 CFR Parts 160 and 164, and 42 CFR Part 2.

2.20 "Platform" means the Rural Health Link Unified Health-Mobility Platform, including all software components, integrations, initial hosting term, and associated documentation.

2.21 "Platform Communication Module" means the Platform's member and provider communication and support function, which may be delivered through web-based interfaces, mobile applications, automated notifications, or other approved channels.

2.22 "Pricing Page" means the pages, contained in wvOASIS or attached as Exhibit A, upon which Vendor should list its proposed price for the Contract Items.

2.23 "Solicitation" means this Request for Quotation (RFQ) as published. 2

2.24 "Subcontractor" means a transportation provider, company, or individual contracted by an Operator to deliver rides under the Operator's program responsibilities. Subcontractors are managed within the Platform under their associated Operator account.

2.25 "Vendor" means the successful bidder, including third-party solutions that is awarded the contract to design, build, deploy, and provide the initial hosting of the Rural Health Link Unified Health‑Mobility Platform.

2.26 "Verified Trip Record" means a completed trip record validated by the Platform through GPS tracking, timestamp confirmation, and member digital signature or equivalent verification, used as the basis for payment data generation.

2.27 "WVHIN" means the West Virginia Health Information Network.

3. GENERAL REQUIREMENTS:

3.1 Contract Items and Mandatory Requirements: Vendor shall provide Agency with the Contract Items listed below. Contract Items must meet or exceed the mandatory requirements as shown below.

3.1.1 Core Platform

The Platform must include, at minimum, the following core capabilities:

3.1.1.1 Real-time ride scheduling and dispatch.

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3.1.1.2 Patient eligibility verification supporting Medicaid and uninsured pathways.

3.1.1.3 Dispatcher dashboard with real-time trip visibility and GPS tracking.

3.1.1.4 Member Portal through which members and facilities will schedule, manage, and track transportation requests.

The Member Portal may be web-based, mobile application based, or both.

3.1.1.5 Automated notifications to members and providers via text, voice, email, or in-app notification delivered through the Member Portal or Platform Communication Module.

3.1.1.6 Closed-loop trip confirmation.

3.1.1.7 Appointment-triggered ride scheduling via EHR integration or other applicable systems.

3.1.1.8 Ride fulfillment tracking tied to completed healthcare encounters.

3.1.1.9 Driver mobile application with manifests, navigation, and live status updates.

3.1.1.10 Web-based or app-based provider inquiry system enabling EMT providers to access trip authorization information, status of trip requests, and member eligibility information.

3.1.1.11 Ability to process and handle urgent, same-day, evening, weekend, and holiday trip requests.

3.1.1.12 Automated rescheduling workflow for provider no-shows, late arrivals, and trip cancellations.

3.1.1.13 The platform must provide predictive transportation demand forecasting capabilities, identification of high-utilization members, automated recurring trip scheduling, identification of transportation deserts, and route optimization opportunities.

3.1.1.14 Multi-modal platform architecture capable of integrating with and managing diverse transportation resources beyond traditional NEMT, including public transit systems, volunteer driver programs, faith-based transportation organizations, community transportation providers, and future transportation partners, with specific support for addressing fragmented transportation in rural communities.

3.1.2 Driver and Transportation Provider Compliance Module

The Platform must include a driver and transportation provider compliance module supporting a multi-tier provider structure (Operator, Subcontractor, and Driver) capable of, but not limited to:

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3.1.2.1 Operator account management with administrative oversight of all associated subcontractors and drivers.

3.1.2.2 Subcontractor profile management under each Operator

including company credentialing, licensing, and insurance documentation.

3.1.2.3 Driver profile management including storage of credentialing and qualification documentation at both the Subcontractor and Driver level.

3.1.2.4 Driver license and CDL tracking with automated expiration alerts.

3.1.2.5 Insurance documentation tracking at both the Subcontractor company level and individual Driver level with automated expiration alerts.

3.1.2.6 Background check status and renewal tracking.

3.1.2.7 Vehicle inspection records and compliance documentation.

3.1.2.8 CPR, first aid, and HIPAA training completion tracking.

3.1.2.9 Drug and alcohol testing compliance record tracking.

3.1.2.10 Automated alerts for upcoming credential expirations at configurable lead times.

3.1.2.11 Compliance status reporting across the Operator, Subcontractor and Driver network.

3.1.2.12 Automated blocking of non-compliant Drivers or

Subcontractors from trip assignments until documentation is current.

3.1.3 Driver, Subcontractor, and Operator Performance Management The Platform must include performance management capabilities across all provider tiers including but not limited to:

3.1.3.1 On-time pickup and drop-off rate tracking at the Driver, Subcontractor, and Operator level.

3.1.3.2 Patient satisfaction scoring via automated post-ride feedback.

3.1.3.3 Incident reporting and tracking including accidents, complaints no-shows, and late arrivals at each provider tier.

3.1.3.4 Performance dashboards accessible to Dispatchers, Operators and Agency administrators at appropriate permission levels.

3.1.3.5 Automated performance threshold alerts flagging Drivers, Subcontractors, or Operators falling below defined benchmarks.

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3.1.3.6 Performance history tied to Subcontractor and Operator contract renewal decisions.

3.1.3.7 Performance reports exportable for state oversight and auditing.

3.1.3.8 Tiered response system: first threshold breach triggers warning notification; second breach triggers mandatory review flag;

third breach triggers automatic suspension from dispatch pending investigation.

3.1.4 Interoperability and Integration Requirements

The Platform must support the following interoperability and integration requirements:

3.1.4.1 FHIR R4 and HL7 v2 compliance for clinical data exchange.

3.1.4.2 Clinical data exchange through state-approved pathways including but not limited to WVHIN, direct EHR integration, or other designated health information exchanges as determined by Agency during contract execution.

3.1.4.3 Once completed, bi-directional integration with the West Virginia Data Spine to support analytics, reporting, and predictive healthcare initiatives. Vendor must participate in Data Spine integration planning and testing as directed by the Agency. Full Data Spine integration timelines will be coordinated with the Data Spine project team.

3.1.4.4 Capable of integrating with the West Virginia MMIS for member eligibility verification. The Platform must be capable of accepting weekly member and provider extract files from the Agency's Third-Party Administrator (TPA).

3.1.4.5 Multi-modal transportation network coordination including NEMT brokers, and public transit systems via API.

3.1.4.6 Medicaid billing and claims integration.

3.1.4.7 The platform must provide fully documented, publicly

accessible APIs or connector capabilities to ingest and exchange real-time availability and scheduling data with public transit, volunteer, and community-based transportation systems to support seamless multi-modal coordination.

3.1.5 Security, Compliance, Privacy, Business Continuity and Reliability The Platform must meet the following security, compliance, and reliability requirements:

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3.1.5.1 HIPAA-compliant architecture with documented PHI

handling procedures per 45 CFR Parts 160 and 164.

3.1.5.2 NIST SP 800-53 Rev. 5 Moderate controls.

3.1.5.3 Role-Based Access Controls (RBAC) aligned to NIST SP

800-53 Rev. 5 AC-2, AC-3, AC-5, and AC-6, including:

3.1.5.3.1 Defined roles for Agency Administrator, Operator

Administrator, Subcontractor Administrator, Driver, Member, and System Auditor.

3.1.5.3.2 Enforcement of least privilege and separation of duties.

3.1.5.3.3 Multi-Factor Authentication (MFA) for all

administrative, Operator, and Subcontractor accounts.

3.1.5.3.4 Prohibition on shared accounts and mandatory unique user identifiers.

3.1.5.3.5 Privilege-escalation alerts and approval workflows.

3.1.5.3.6 Session timeout and reauthentication for PHI access.

3.1.5.3.7 Ability to restrict access at the data-element level (e.g., PHI fields, payment data, and credentialing documents).

3.1.5.3.8 Logging of all RBAC changes in the audit log.

3.1.5.4 RBAC must be fully testable during Agency security validation and must support FedRAMP aligned access control expectations.

3.1.5.5 Web‑based and mobile interfaces must comply with ADA

accessibility requirements and Section 508 standards (Section 508 of the Rehabilitation Act of 1973). The solution must conform to the current applicable version of Web Content Accessibility Guidelines, Level AA at the time of deployment, including all relevant success criteria for both desktop and mobile accessibility.

3.1.5.6 All relevant State and Federal Data Privacy Laws, Regulations, and Policies.

3.1.5.7 Maintain immutable, tamper-evident audit logs meeting NIST/SP 800-53 Rev. 5 AU-2, AU-3, AU-6, AU-8, and AU-9 requirements.

Logs must:

3.1.5.7.1 Capture user ID, role, IP address, device ID, timestamp (UTC), action type, object acted upon, and before/after values for data modifications.

3.1.5.7.2 Record all logins, failed logins, data views, edits, deletions, exports, RBAC changes, administrative actions, and API access.

3.1.5.7.3 Be stored in a WORM (Write Once, Read Many)

equivalent or otherwise tamper-evident format

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3.1.5.7.4 Be retained for 6 years and exportable in proprietary formats (CSV, JSON).

3.1.5.7.5 Be accessible only to authorized Agency personnel.

3.1.5.7.6 Be protected from alteration by Vendor personnel, except for system-level maintenance that is itself logged

3.1.5.8 Audit logs must be available for federal and state audits including CMS, HHS, and WV OMIS (Office of Management Information Services).

3.1.5.9 If a data breach is discovered or suspected the Vendor shall immediately follow the process outlined in the most recent version of the Office of Management Information Services OP-30 Incident Reporting and Response Procedures, (Procedure - OP-30 – Incident Reporting and Response).

3.1.6 Hosting Requirements

Hosting infrastructure provided by or subcontracted by Vendor must satisfy the following:

3.1.6.1 Maintain an Incident Response capability aligned to NIST SP 800-61 Rev. 2, including a documented Incident Response Plan covering detection, analysis, containment, eradication, recovery, and post-incident review. All security incidents must be reported to the Agency immediately upon discovery and no later than fifteen (15) minutes, consistent with OP-30, using the required WVOT Incident Reporting System and concurrent notification to the OMIS Incident mailbox.

Hosting vendor shall participate in joint incident response exercises with the Agency and provide incident logs, forensic artifacts, and related evidence upon request.

3.1.6.2 Ensure that data maintained by the platform is not used, released, or sold without specific authorization from the Agency, regardless of whether the data has been de-identified or included with a limited data set.

3.1.6.3 Certify that it is not currently under investigation by any state or federal authority for a breach of data security.

3.1.6.4 Disclose whether it has been involved in any breach of data security in the last 10 years, any ongoing investigations, and provide details relating to the causes of the breach and the mitigating actions taken in response to the breach.

3.1.6.5 The hosting vendor must disclose any material changes to the hosting environment and any subcontractors with access to the hosting environment.

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3.1.6.6 Maintain a documented Business Continuity Plan and Disaster Recovery plan aligned to NIST SP 800-34, rev. 1 for the platform environment.

3.1.6.6.1 Plans must include Recovery Time Objective (RTO)

and Recovery Point Objective (RPO) definitions.

3.1.6.6.2 Provide copies of its BCP and DR plans to the Agency within 60 calendar days of contract execution and request thereafter.

3.1.6.6.3 Plans must be aligned with the most current version of NIST SP 800‑34 (Contingency Planning Guide for Federal Information Systems) or success or publications, throughout the contract term.

3.1.6.6.4 Conduct annual BCP/DR testing (tabletop or live

failover exercises) and provide a summary report of results, corrective actions, and remediation timelines to the Agency within 30 calendar days of test completion.

3.1.6.6.5 Update BCP/DR plans within 60 calendar days of

lessons learned from testing, incidents, or material changes to the hosting environment.

3.1.6.6.6 Annually certify to the Agency that its BCP/DR plans remain current, tested, and compliant with federal and state requirements.

3.1.6.7 Shall provide hosting infrastructure that meets federal‑grade security and compliance requirements, including FedRAMP Moderate or GovRAMP Moderate authorization and full alignment with NIST SP 800‑53 Rev. 5 Moderate controls.

3.1.6.8 NIST SP 800-53 Rev. 5 Moderate Compliance.

3.1.6.9 Evidence that all Platform data is stored and processed exclusively with U.S.‑based data centers, in compliance with federal government and the State of West Virginia’s cybersecurity and data residency requirements.

3.1.6.10 Support for compliance with applicable Executive Branch and Office of Management Information Services (OMIS) Security Policies.

3.1.6.11 Document hosting provider selection and demonstrate compliance with this requirement prior to contract execution. Hosting costs must be included in Vendor's bid pricing. The agency will not accept separate invoices from hosting providers.

3.1.7 Reporting & Analytics

The Platform must include reporting and analytics capabilities including but not limited to:

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3.1.7.1 Customizable dashboards are accessible to Agency

administrators, Operators, and Subcontractors at appropriate permission levels.

3.1.7.2 Utilization reports tied to care delivery outcomes.

3.1.7.3 Performance metrics exportable for state oversight.

3.1.7.4 Monthly Platform Communication Module and trip summary reporting.

3.1.7.5 Fraud, waste, and abuse detection reporting with automated flags for anomalies, duplicate billing, and unusual utilization patterns.

3.1.7.6 Platform utilization, ride volumes, healthcare encounter linkage rates, uptime statistics, and security compliance status reporting.

3.1.7.7 For all collected and reported metrics, vendors must submit and maintain a State‑approved data dictionary with technical specifications.

3.1.7.8 The platform must provide performance reports on rural access metrics, including reduction in transportation barriers, rural healthcare access improvements, missed appointment reduction, and trip completion rates in underserved counties.

3.1.8 Platform License, Data Ownership and Transition Requirements Vendor must comply with the following:

3.1.8.1 Agency requires the outright, exclusive assignment of all Intellectual Property rights to the Agency (work-for-hire). The assignment shall survive contract termination for any reason.

3.1.8.2 All data, reports, dashboards, workflows, and other work products generated under this program shall be accessible to the State in real time and shall be considered State program assets.

3.1.8.3 All data must be maintained in portable, non-proprietary formats exportable by Agency on demand at any time without vendor permission or involvement.

3.1.8.4 Platform must expose fully documented, publicly accessible APIs so Agency or any third party can connect to, extend, or maintain the Platform independently.

3.1.8.5 Complete technical documentation must be delivered to Agency including architecture diagrams, API specifications, data schemas, and deployment guides.

3.1.8.6 Vendor must agree that all data related to the execution of the contract is collected on behalf of and remains the sole property of the Agency.

3.1.8.7 Vendor must agree to provide privacy and security safeguards to protect all data from any use or disclosure for any purpose other than the described within this solicitation.

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3.1.8.8 Vendor must return the entire dataset in a specified format upon request or contract termination at no additional cost and in a format specified by the Agency to ensure usability and accessibility.

3.1.8.9 Vendor must cooperate with the Agency and any subsequent

Vendor should the contract, which is the subject of this RFQ, be terminated, and deliver any and all data, documentation, and associated work products to the Agency or its designee within thirty (30) working days of receipt of notice of contract termination.

3.1.8.10 Vendor must destroy all data in the System at the end of the contract and/or upon the request of the Agency in accordance with the most current version of the National Institute of Standards and Technology (NIST) Special Publication 800-88. Destruction of data shall not begin prior to receipt of written authorization from the Agency and must be completed within 30 days of receipt of that authorization.

3.1.8.11 Vendor must provide training and implementation support for up to 50 Agency designated end users or operators, either virtually or onsite. Training must also be video recorded for Agency use after contract completion. All travel and materials cost must be included in total bid amount.

3.1.8.12 Upon contract termination or vendor exit, Vendor must provide a transition assistance period of no less than 90 days to Agency or a replacement vendor at no additional cost. Returning all Agency data in a usable, non-proprietary format (e.g., CSV or SQL).

Documented "handoff" meetings, walkthroughs of system architecture, and training for the new team to prevent "vendor lock-in". Vendor continues to run the production environment while the new vendor sets up, ensuring there is no gap in service.

Revoking vendor's credentials while transferring "master" or

"root" admin rights back to the Agency. Maintaining a dedicated contact person for "break-fix" issues that arise specifically because of migration.

3.1.9 Data Systems Requirements

The Platform must meet the following data systems requirements:

3.1.9.1 Weekly eligibility verification: Platform must be capable of processing member and provider extract files provided by the

Agency TPA and reconcile any discrepancies.

3.1.9.2 Member eligibility determination: Platform must support real time eligibility determination for members requesting Data capture: Platform must capture and retain data sufficient to meet contract reporting requirements and support state and federal audits.

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3.1.9.4 Encounter data: Platform must be able to generate a monthly aggregate encounter data file containing all trips made on behalf of Agency members.

3.1.9.5 Mileage calculation: Platform must use software-based mileage calculation.

3.1.10 Payment Data Module

The Platform must include a payment data module to support Operator reimbursement of Subcontractors. The Platform does not process or transmit actual payments. All money movement remains the responsibility of the Operator.

The payment data module must include, at minimum, the following:

3.1.10.1 Verified Trip Records generated for each completed trip.

3.1.10.2 Automated claims adjudication that cross-checks trip data against driver credentialing records, GPS logs, and member eligibility.

Trips involving non-credentialed drivers or unverified completion are automatically flagged and excluded from payment data pending review.

3.1.10.3 Per-Subcontractor earnings summaries calculated against Agency approved rate schedules, broken down by trip, service type, and billing period.

3.1.10.4 Explanation of Payment (EOP) reports accessible to Operators and Subcontractors through their portal accounts, detailing trip-level payment calculations, adjudication status, and denial reasons where applicable.

3.1.10.5 Exportable payment files in standard formats compatible with ACH processing systems and common accounting software, enabling Operators to process Subcontractor payments through their own financial systems.

3.1.10.6 Mileage reimbursement calculation for volunteer or personal vehicle trips based on pre-authorized routes and software-verified distances.

3.1.10.7 Denied claim detail with documented explanation and

resubmission pathway for Subcontractors.

3.1.10.8 Payment data retention sufficient to support state and federal audits.

3.1.11 Vendor Qualifications

3.1.11.1 Vendor must provide at least three verifiable client references for completed software projects.

3.1.11.2 Vendor must have demonstrated HIPAA and 42 CFR Part 2 compliance and experience handling PHI at scale.

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3.1.11.3 Vendor must have no active federal or state contract debarments.

3.1.11.4 Vendor must demonstrate one of the following: (a) previous mobility platform development; OR (b) a documented acquisition or licensing strategy identifying named codebase candidates, evidence of preliminary discussions or letters of intent with code owners, a technical assessment of the codebase, an enhancement plan aligned with Platform requirements, and an acquisition timeline compatible with the live deployment requirement.

3.1.11.5 Consortium bids are permitted. The lead vendor must meet all mandatory qualifications. Partner vendors must meet qualifications relevant to their defined scope of work. The resulting contract will be issued to the lead vendor who is responsible for the performance of consortium vendors.

Consortium structure and responsibilities must be clearly documented in the bid response.

4. CONTRACT AWARD:

4.1 Contract Award: The Contract is intended to provide Agencies with a purchase price on all Contract Items. The Contract shall be awarded to the Vendor that provides the Contract Items meeting the required specifications for the lowest overall total cost as shown on the Pricing Pages.

4.2 Pricing Pages: Vendor should complete the Pricing Pages by entering the unit prices on the commodity lines. Vendor should complete the Pricing Pages in their entirety as failure to do so may result in Vendor’s bids being disqualified. Vendor should electronically enter the information into the Pricing Pages through wvOASIS, if available, or as an electronic document.

4.3 Milestone Payment Structure: Payments will be released upon Agency approval of milestone deliverables as follows. Payments are released at the end of each milestone month upon Agency written approval. The Agency will review milestone completion reports within 10 business days of submission. If deliverables are rejected, Vendor has 15 business days to cure deficiencies. Milestone payments are tied to Vendor performance and platform readiness, not to operational deployment volume. Where deployment is delayed due to the transition timeline of an existing state transportation services contract and not due to any deficiency in Vendor performance or platform readiness, milestone payments shall not be withheld provided Agency certifies that all technical deliverables for that milestone are complete.

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Milestone 1 - End of Month 1 (15%)

• Core team assembled and identified by name.

• Development environment live.

• Code acquisition letter of intent or existing codebase documentation submitted.

• Project plan with weekly deliverables submitted and approved.

Milestone 2 - End of Month 3 (15%)

• Technical architecture document approved by Agency.

• Data Spine and WVHIN integration specifications documented as applicable.

• MMIS integration design approved by Agency.

• Multi-tier provider structure (Operator, Subcontractor, and Driver) architecture approved by Agency.

• Payment data module design including adjudication logic and EOP report structure approved by Agency.

• Core platform modules in active development with demonstrated progress.

• Driver compliance module design approved by Agency.

Milestone 3 - End of Month 5 (15%)

• Core platform functions in staging environment including scheduling, dispatch, routing, member portal, web-based provider inquiry system, multi-tier provider management, payment data module, and driver compliance module.

• State-approved demonstration of staging environment completed.

• Business continuity and disaster recovery plan submitted to Agency for approval.

Milestone 4 - End of Month 6 (20%)

• Platform live in production environment and certified ready for active use.

• Driver compliance module operational.

• Member portal live.

• Web-based provider inquiry system live.

• Operator and Subcontractor account management live.

• Payment data module live and generating Verified Trip Records.

• Payment data module processing claims with documented adjudication accuracy rate.

• Medicaid billing integration established.

• Platform training and onboarding of Agency designated group.

• NOTE: Milestone 4 payment is released upon Agency certification that the Platform meets all production requirements, regardless of whether active ride dispatching has commenced. If operational deployment is delayed due to the transition timeline of an existing state transportation services contract rather than vendor performance deficiency, Milestone 4 payment shall not be withheld provided Agency certifies the Platform is production-ready and all technical deliverables are complete.

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Milestone 5 - End of Month 8 (15%)

• WVHIN integration operational.

• Data Spine integration active.

• EOP reports accessible to Operators and Subcontractors through portal.

• First exportable payment file successfully generated and validated.

• Performance reporting dashboard live and accessible to Agency, Operators, and

Subcontractors at appropriate permission levels.

• First monthly encounter data file delivered to Agency.

• NOTE: If operational deployment has not yet commenced due to an existing state transportation services contract transition timeline, Milestone 5 payment shall be released upon Agency certification that all platform integrations are live, tested, and production-ready.

Milestone 6 - End of Month 12 (20%)

• Driver and Subcontractor compliance module fully populated and enforcing automated compliance blocking.

• Complete technical documentation delivered to Agency.

• Vendor must submit documentation evidencing a third-party assessment based on NIST

800-53 rev.5 controls or active pursuit with documented timeline submitted.

5. ORDERING AND PAYMENT:

5.1 Ordering: Vendor shall accept orders through wvOASIS, regular mail, facsimile, e-mail, or any other written form of communication. Vendor may, but is not required to, accept on-line orders through a secure internet ordering portal/website. If Vendor has the ability to accept on-line orders, it should include in its response a brief description of how Agencies may utilize the on-line ordering system. Vendor shall ensure that its on-line ordering system is properly secured prior to processing Agency orders on-line.

5.2 Payment: Vendor shall accept payment in accordance with the payment procedures of the State of West Virginia.

6. DELIVERY AND RETURN:

6.1 Delivery Time: Vendor shall deliver a fully operational Platform within 12 months of contract execution in accordance with the milestone schedule. Vendor shall not end-load deliverables.

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6.2 Late Delivery: The agency must be notified in writing if any milestone delivery will be delayed for any reason. Any delay attributable to Vendor performance deficiency that could cause harm to Agency or to the platform deployment timeline may be grounds for milestone payment withholding and claw back per Section 7. Delays caused solely by the transition timeline of an existing state transportation services contract shall not be treated as a Vendor delivery failure.

6.3 Return of Unacceptable Items: If the Agency deems milestone deliverables to be unacceptable, Vendor shall be notified in writing with documented deficiencies. Vendor shall have 15 business days to cure deficiencies. If deficiencies are not cured within the cure period, the Agency may withhold the associated milestone payment and initiate default procedures per Section 7.

7 VENDOR DEFAULT:

7.1 The following shall be considered a vendor default under this Contract.

7.1.1 Failure to provide Contract Items in accordance with the requirements contained herein.

7.1.2 Failure to comply with other specifications and requirements contained herein.

7.1.3 Failure to comply with any laws, rules, and ordinances applicable to the Contract Services provided under this Contract.

7.1.4 Failure to remedy deficient performance upon request.

7.1.5 Failure to deliver a production-ready Platform by the end of Month 6.

7.1.6 Failure to achieve Month 12 performance metrics where such failure is attributable to Vendor performance deficiency and not to delayed operational deployment caused by an existing state transportation services contract transition.

7.1.7 Failure to comply with HIPAA, NIST 800-53, or other required security, privacy, and/or compliance standards.

7.1.8 Failure to provide audit access to Agency or federal personnel within the required timeframe.

7.1.9 Failure to deliver complete technical documentation or transition assistance upon contract termination or vendor exit.

Rural Health Link: Unified Health-Mobility Platform

Revised 10/27/2014

7.2 The following remedies shall be available to Agency upon default.

7.2.1 Immediate cancellation of the Contract.

7.2.2 Immediate cancellation of one or more release orders issued under this

Contract.

7.2.3 Claw back of previously paid milestone amounts where associated deliverables were not sustained.

7.2.4 Any other remedies available in law or equity.

8 MISCELLANEOUS:

8.1 No Substitutions: Vendor shall supply only Contract Items submitted in response to the Solicitation unless a contract modification is approved in accordance with the provisions contained in this Contract.

8.2 Vendor Capacity: Vendor certifies it has the technical capacity, staffing, and financial resources to fulfill the Contract Items contained in its bid response within the timeline specified.

8.3 Reports: Vendor shall provide quarterly reports and annual summaries to the Agency showing the Agency’s items purchased, quantities of items purchased, and total dollar value of the items purchased. Vendor shall also provide reports, upon request, showing the items purchased during the term of this Contract, the quantity purchased for each of those items, and the total value of purchases for each of those items. Failure to supply such reports may be grounds for cancellation of this Contract.

Rural Health Link: Unified Health-Mobility Platform

Revised 10/27/2014

8.4 Separation of Technology and Operations Contracts: This Solicitation covers the development of a technology platform only. A separate solicitation will cover statewide transportation operations and brokerage services. These are independent procurements governed by separate awards.

Vendors may bid on and be awarded both this technology platform contract and the operations contract. However, each award is governed solely by its own contract terms, performance requirements, and payment structure. Award of one contract does not confer any preference, advantage, or obligation in connection with the other. A vendor holding both awards must maintain a clear separation between platform technology obligations and operational service obligations and must not use either contract to satisfy requirements of the other.

8.5 Contract Manager: During its performance of this Contract, Vendor must designate and maintain a primary contract manager responsible for overseeing Vendor’s responsibilities under this Contract. The Contract manager must be available during normal business hours to address any customer service or other issues related to this Contract. Vendor should list its Contract manager and his or her contact information below.

Contract Manager: ______________________ Telephone Number: ________________________ Fax Number: ______________________________ Email Address: ____________________________