S-44300-00017151- MES Attachment D Reference Check Form.docx

This is a Reference Check Form attachment for a Request for Proposal issued jointly by the State of Oregon, acting through the Oregon Health Authority (OHA) and Oregon Department of Human Services (ODHS), for Medicaid Enterprise System (MES) System Integration Services. The form is designed to be completed by reference entities to evaluate proposer qualifications and past performance. The reference check instrument requests information regarding the type of services provided by the proposer, assessment of customer service quality, overall satisfaction with the business relationship, problem resolution methods, likelihood of future engagement, and specific aspects of services that were most and least satisfactory to the reference.

The form also requires references to evaluate the proposer's adherence to project timelines and cost management, comparing final project costs against initial proposals. Respondents are asked to provide contact information for the proposer, the reference entity name, and a contact person with telephone number and email address. This reference check form serves as a mechanism for the State of Oregon to verify proposer experience and performance history as part of the evaluation process for the MES System Integration Services procurement.