RY23 Chronic Disease Rehab Hospitals RFA - Rev 1.docx

Commonwealth of Massachusetts Executive Office of Health and Human Services One Ashburton Place Boston, MA 02108

REQUEST FOR APPLICATIONS

CHRONIC DISEASE AND REHABILITATION HOSPITAL

MASSHEALTH PROGRAM

RATE YEAR 2023

Issued: September 15, 2022

Document Number: 23LCEHSCDRHOSPITALRFA

TABLE OF CONTENTS

ATTACHMENTS:

Attachment A: Application for Participation Attachment B: Additional Required Documents and Information Attachment C: Contractor Certification Form Attachment D: CDR Hospital Contract

INTRODUCTION

Procurement Purpose The Massachusetts Executive Office of Health and Human Services “EOHHS”, as the single state agency responsible for administering the Massachusetts Medicaid program known as “MassHealth”, is issuing this Request for Applications (RFA) to solicit applications from eligible, in-state Chronic Disease and Rehabilitation Hospitals (CDR Hospital) wishing to participate as MassHealth providers of CDR Hospital services as described in Attachment D, the CDR Hospital Contract.

EOHHS is issuing this RFR pursuant to 801 CMR 21.00, which governs procurement of services by State agencies. EOHHS makes no guarantee that any services will be purchased as a result of this RFA or from any CDR Hospital Contract resulting from this RFA.

The initial deadline for responses to this RFA is September 27, 2022, at 5PM as specified in Section 7 of the RFA. Responses will be accepted after the initial deadline under the open enrollment process described in Section 6.13 of the RFA.

Applicants wishing to respond to this RFA must complete and execute the enclosed RFA attachments, including Attachment D, which is the MassHealth CDR Hospital Contract. Any existing CDR Hospital Contracts as of the posting of this RFA shall terminate on September 30, 2022.

Applicant Qualifications EOHHS seeks to contract with multiple qualified Applicants to provide CDR Hospital services to MassHealth Members as described in Attachment D, CDR Hospital Contract.

To be considered for contract award pursuant to this RFA, an Applicant, in addition to all other requirements specified in this RFA, must:

Be a non-state-operated CDR Hospital located in Massachusetts and meet all of the participating provider requirements contained in MassHealth regulations at 130 CMR 435.404 (B);

Utilize a majority of its beds to provide chronic disease services and/or comprehensive rehabilitation services to patients with appropriate medical needs. In determining whether the Applicant satisfies this utilization requirement, EOHHS may evaluate, pursuant to an on-site audit or otherwise, a number of factors, including, but not limited to, the average length of patient stay;

For CDR hospitals with DPH-licensed psychiatric beds, comply with the staffing ratios as set forth in Attachment D, CDR Hospital Contract;

Maintain and retain any records necessary to disclose the extent, quality and medical necessity of services provided to Members, to substantiate any claims for payment submitted by the Provider to the MassHealth Program, or as otherwise required by EOHHS or applicable law. Such records must be, upon request, made available and provided to EOHHS, its designees, the Office of the Attorney General’s Medicaid Fraud Division (MFD), the federal Centers for Medicare & Medicaid Services, and other government agencies as provided in applicable law; and As set forth in Appendix D CDR Hospital Contract, transition to electronic medical records (EMR) for all inpatient services in its facility by October 1, 2023. If the Applicant fails to complete its transition to EMR by the above date, EOHHS reserves the right to apply a downward adjustment of up to 10% of the Contractor’s inpatient per diem rate.

Contract Term The anticipated contract effective date is October 1, 2022. Any contract awarded as a result of this RFA will be effective through September 30, 2023. At EOHHS’s option, the CDR Hospital Contract may be extended for up to four additional years in any increment, subject to the Contractor’s satisfactory performance as determined by EOHHS, of all duties under the Contract

DEFINITION OF TERMS

The terms or their abbreviations, when capitalized in this RFA and its Attachments, are defined in Section 1 of Attachment D CDR Hospital Contract.

PAYMENT

CDR Hospitals that choose to participate in the MassHealth Program under the terms of the CDR Hospital Contract, shall accept payment at the rates pursuant to Appendix 1 of Attachment D (the CDR Hospital Contract) as payment in full for all Inpatient Services, Outpatient Services, and short-term Administrative Days rendered on and after October 1, 2022, through the term of the CDR Hospital Contract. See Section 4 of Attachment D, CDR Hospital Contract for payment terms.

In addition to payments as described above, CDR Hospitals that choose to participate in the MassHealth Program under the terms of the CDR Hospital Contract may qualify for Quality Performance Incentive Payments or for Supplemental Payments. See Appendix 3 of Attachment D, CDR Hospital Contract for additional information on Quality Performance Incentive Payments and Supplemental Payments.

SUBMISSION REQUIREMENTS

Contents of Submission Applicants wishing to respond to this RFA must complete and execute the following RFA attachments, including Attachment D CDR Hospital Contract. Each Applicant’s response to the RFA must consist of the following:

Cover Letter The cover letter must be signed by the individual authorized to execute Attachment D, CDR Hospital Contract for the Applicant and shall contain the name, title, email address, and telephone number of the individual who should be contacted for the purpose of clarifying the response.

Attachment A, Application for Participation The Application for Participation must be completed in its entirety and submitted in accordance with the instructions therein. As part of the Application for Participation the Applicant must certify that the information and supporting documentation submitted in response to this RFA (such as licenses, certificates, and permits) is current, correct, and complete.

Attachment B, Additional Required Documents and Information The additional required documents and information specified in Attachment B must be completed and provided in accordance with the instructions therein.

Attachment C, Contractor Certification The Certification must be completed and signed in accordance with the instructions therein.

Attachment D, the MassHealth Chronic Disease and Rehabilitation Hospital Contract The MassHealth CDR Hospital Contract will become the MassHealth provider participation agreement between EOHHS and each CDR Hospital for each Applicant awarded a contract as a result of this RFA. A properly completed and signed Attachment D CDR Hospital Contract, without modification to terms, must be submitted as part of the Applicant’s response to this RFA. EOHHS will sign the contract upon its acceptance of an Applicant’s response to this RFA.

Quality Measures As part of its response to the RFA, each Applicant must submit all information that may be specified in Appendix 2 of Attachment D (the CDR Hospital Contract).

Responsiveness Each document submitted in response to this RFA must include all information specified to the topic of the document as required by this RFA. EOHHS will evaluate only those materials that are responsive to this RFA and submitted in accord with the instructions in Section 4.

Submission Instructions Each Applicant must submit an electronic copy of its submission via email to:

Meera Ramamoorthy Institutional Program Manager Nursing Facilities | Chronic Disease & Rehabilitation Hospitals MassHealth Office of Long Term Services and Supports meera.e.ramamoorthy@mass.gov

Closing Dates Applicants currently participating in the MassHealth Program as a CDR Hospital must submit timely, accurate and complete responses to this RFA, including all information specified in the Attachments, by the date and time specified in Section 7, Procurement Timetable, in order to ensure uninterrupted participation in the MassHealth Program.

RESPONSE AND PROVIDER SELECTION

EOHHS will review all responses submitted in accordance with the terms of this RFA. Each application will be reviewed to determine whether the Applicant meets the requirements of this RFA as described in Section 1.2 and Section 4. Those Applicants that meet all of the applicant qualifications and submission requirements will be awarded a CDR Hospital Contract and may participate as a CDR Hospital provider in the MassHealth Program.

Any submission determined to be non-responsive to any requirement of this RFA may be rejected. EOHHS may determine that non-compliance is insubstantial and can be corrected. In such cases, EOHHS may, at its discretion, seek clarification, allow the Applicant to make corrections, and/or allow the Applicant to submit additional information. All such responses to EOHHS requests for clarification must be in writing, unless otherwise specified by EOHHS.

An Applicant may not be awarded a CDR Hospital Contract if it fails to meet any one of the following criteria:

Meet the Applicant Qualifications specified in Section 1.2.

Submit a complete response to this RFA in accordance with Section 4 by the deadline for responses to this RFA specified in Section 7.

RFA INFORMATION

Issuing Office Commonwealth of Massachusetts Executive Office of Health and Human Services Office of Medicaid One Ashburton Place, 11th floor Boston, MA 02108

801 CMR 21.00

The terms of 801 CMR 21.00, Procurement of Commodities and Services, are incorporated by reference into this RFA. Words used in this RFA must have the meanings defined in 801 CMR 21.00. Additional definitions are also identified in Section 1 of the CDR Hospital Contract. Unless otherwise specified in this RFA, all communications, responses, and documentation must be in English, all measurements must be provided in feet, inches, and pounds, and all cost proposals or figures in U.S. currency. All responses must be submitted in accordance with the specific terms of this RFA.

COMMBUYS

COMMBUYS is the official source of information for this RFA and is publicly accessible at no charge at www.commbuys.com. The RFA, and any RFA attachments and amendments, are all components of the RFA, and are incorporated into the RFA and any resulting contract.

Applicants are solely responsible for obtaining and completing required attachments that are identified in this RFA and for obtaining all information distributed for this RFA via COMMBUYS.

It is also each applicant’s responsibility to check COMMBUYS for:

A. Any amendments, addenda or modifications to this RFA; and B. Any RFA Q&A records that may be posted related to this RFA.

The Commonwealth accepts no responsibility and will provide no accommodation to applicants who submit a response based on an out-of-date RFA or on information received from a source other than COMMBUYS. Applicants may not alter (manually or electronically) the RFA language or any RFA component files. Modifications to the body of the RFA, specifications, terms and conditions, or which change the intent of this RFA are prohibited and may disqualify a response.

COMMBUYS Subscription. Applicants may elect to obtain a free COMMBUYS subscription which provides value-added features, including automated email notification associated with postings and modifications to COMMBUYS records.

The COMMBUYS system introduces new terminology, which applicants must be familiar with in order to conduct business with the Commonwealth. To view this terminology and to learn more about the COMMBUYS system, please visit the COMMBUYS Resource Center.

Applicant Communications Applicants are prohibited from communicating directly with any employee of EOHHS about this RFA, except as specified in this RFA, and no other individual federal or State employee or representative is authorized to provide any information or respond to any question or inquiry concerning this RFA. Applicants may contact the contact person for this RFA in the event this RFA is incomplete, or the Applicant is having trouble obtaining any documents or attachments electronically through COMMBUYS. Applicants may request a copy of the RFA, or any of its components, by contacting the RFA contact person named below.

RFA Contact:

Meera Ramamoorthy Institutional Program Manager Nursing Facilities | Chronic Disease & Rehabilitation Hospitals MassHealth Office of Long Term Services and Supports meera.e.ramamoorthy@mass.gov

Reasonable Accommodation Applicants with disabilities or hardships that seek reasonable accommodation, which may include the receipt of RFA information in an alternative format, must submit a written statement to the RFA contact person describing the Applicant’s disability and the requested accommodation to the contact person for the RFA. EOHHS reserves the right to reject unreasonable requests.

RFA Copies Applicants may request a copy of the RFA, or any of its components by contacting the individual identified in Subsection 6.4.A. above.

Addendum or Withdrawal of RFA If it becomes necessary to revise any part of this RFA, or if additional data is necessary to clarify any of its provisions, a supplement will be posted on COMMBUYS (see Section 6.3 for information on COMMBUYS). EOHHS reserves the right to amend the RFA at any time and to terminate this procurement in whole or in part at any time.

Rate Exception Procedure The rates of payment for each hospital are as stated in Attachment D CDR Hospital Contract, at Appendix 1. The rates are computed in accordance with the methods and standards set forth in a Notice of Agency Action available under the hyperlink Special Notices for Chronic Disease and Rehabilitation Hospitals. Note that there may be separate notices or methodologies for subtypes within the CDR Hospital category.

If a transcription error occurred or if the incorrect line was transcribed in the calculation of a Hospital’s Base Year Inpatient Operating Costs used in the calculation of the Inpatient Per Diem Rate, a correction can be made prior to contract execution. Such corrections will not affect any of the efficiency standards applied to inpatient costs or the allowance for inpatient capital. To request a correction, an applicant must submit written evidence of data error no later than the date specified in Section 7 to the address specified in Section 6.4.A. Such written evidence shall include a copy of the relevant report(s), highlighting the item(s) believed to be in error, along with evidence of the correct amounts. EOHHS will review a timely request for a correction and will inform the applicant of the results of its review. If a data error is found, EOHHS will issue a revised CDR Hospital Contract Appendix 1, containing the corrected rates.

Anticipated Date of Contractor Selection EOHHS anticipates selection of Contractors by the date specified in Section 7.

Anticipated Date of Contract Commencement EOHHS anticipates that the CDR Hospital Contracts shall commence on October 1, 2022.

Cost of Application No costs or expenses incurred by applicants in submitting a response to this RFA shall be borne by the Commonwealth.

Public Records All applications and related documents submitted in response to this RFA are public records under the Massachusetts Freedom of Information Law, M.G.L. Chapter 66, §10, and Chapter 4, §7, regarding public access to such documents. Statements inconsistent with those statutes will be disregarded.

Limitations This RFA does not commit EOHHS to award a contract, to pay any costs incurred in the preparation of the application, or to procure or contract for services or supplies. EOHHS reserves the right to accept or reject any and all applications received as a result of this request, or to cancel this RFA in any part or in its entirety if it is in the best interest of the MassHealth Program to do so. To the extent that the methodologies require State Plan approval by the Centers for Medicare and Medicaid Services (CMS), Contracts are subject to such approval. EOHHS reserves the right to amend the reimbursement methodology as necessary to meet federal requirements.

Return of Applications The Commonwealth shall be under no obligation to return any materials submitted by an applicant in response to this RFA.

Confidentiality, Privacy and Security of Health Information Applicants shall comply with all state and federal laws and regulations relating to confidentiality, privacy, and security of health information including but not limited to rules and regulations of CMS and EOHHS. EOHHS may require specific written assurance and further agreements regarding the security and privacy of protected health information that are deemed necessary to implement and comply with standards under the Health Insurance Portability and Accountability act of 1996 (HIPAA) as implemented in 45 CFR, parts 160 and 164.

Open Enrollment This is an “open enrollment” RFA. After the initial open enrollment period, EOHHS reserves the right to reopen the RFA at EOHHS’s discretion, at any time within the duration of the CDR Hospital Contract to accept RFA responses from additional applicants. Information regarding re-opening will be posted on the same COMMBUYS site where this RFA is posted. Any Applicant that submits a response after the initial response deadline and in response to a subsequent open enrollment period must follow the same submission instructions set forth in Section 4. Such responses shall be reviewed and evaluated as described in Section 6. All CDR Hospital Contracts awarded as a result of this RFA will have a start date as designated by EOHHS, and, regardless of the start date, will expire on September 30, 2023, unless otherwise extended in accordance with Section 9.4 of the CDR Hospital Contract.

PROCUREMENT TIMETABLE

5:00 p.m.

RY2023 CDR Hospital RFA 2