S000000092 IFB Medicare Part D and Retiree Subsidy Services.pdf

STATE OF ARKANSAS

DEPARTMENT OF TRANSFORMATION AND SHARED SERVICES

OFFICE OF STATE PROCUREMENT

501 Woodlane St., Ste. 220

Little Rock, Arkansas 72201-1023

INVITATION FOR BID

SOLICITATION DOCUMENT

SOLICITATION INFORMATION

Solicitation Number:

S000000092 Solicitation Issued:

February 22, 2022

Description: Medicare Part D and Retiree Subsidy Services

Department: Arkansas State Police

SUBMISSION DEADLINE AND DELIVERY OF RESPONSE DOCUMENTS

Bid Opening Date: March 16, 2022 Bid Opening Time: 2:00 PM, Central Time

Bid responses for this Invitation for Bid must be submitted through ARBuy, the State’s eProcurement system.

It can be accessed at https://arbuy.arkansas.gov. Bids received after the submission deadline may be rejected as untimely. See section 1.2 for information regarding Live Bid Openings.

TSS OFFICE OF STATE PROCUREMENT CONTACT INFORMATION

TSS OSP Buyer: Brandi Schroeder Buyer’s Direct Phone Number: 501-682-4169

Email Address: Brandi.schroeder@arkansas.gov TSS OSP’s Main Number: 501-324-9316

TSS OSP

Website:

https://www.transform.ar.gov/procurement/ https://arbuy.arkansas.gov/

SECTION 1 – REQUIREMENTS

• Do not provide responses to items in this section unless specifically and expressly required.

1.1 INTRODUCTION

This Invitation for Bid (IFB) is issued by the TSS Office of State Procurement (TSS OSP) for the Arkansas State Police (“ASP” or “Department”) to obtain pricing and a contract for Medicare Part D and Retiree Subsidy Services.

Direct all questions, comments, or concerns you may have regarding this solicitation to the TSS Office of State Procurement, not the ASP.

1.2 LIVE BID OPENING

Use the information below to view the bid opening online.

Zoom Meeting Link: https://arkansas-gov.zoom.us/j/82059056022?pwd=L0dxWTNPTXZnaHk0aEppZm1Qd3FsUT09 Meeting ID: 820 5905 6022 Meeting Password: 834717 Dial-In Information: 877 853 5257 US Toll-free

888 475 4499 US Toll-free

1.3 CLARIFICATION OF SOLICITATION

A. Submit any questions requesting clarification of information contained in this Solicitation via the solicitation posting in ARBuy by 4:00 pm, Central Time on or before February 28, 2022.

1. For each question submitted, Prospective Contractor should reference the specific solicitation item number to which the question refers.

2. Prospective Contractors’ written questions will be consolidated and answered by the State as deemed appropriate. The State’s consolidated written response is anticipated to be posted to the solicitation posting in ARBuy by the close of business on March 4, 2022. If Prospective Contractor questions are unclear or non-substantive in nature, the State may request clarification of a question(s) or decline to answer.

B. The Prospective Contractor should notify the TSS OSP buyer of any term, condition, etc., that precludes the Prospective Contractor from submitting a compliant, Responsive Bid. Prospective Contractors should note that it is the responsibility of the Prospective Contractor to seek resolution of all such issues, including those relating to the terms and conditions of the contract, prior to the submission of a bid.

C. Prospective Contractors may contact the TSS OSP buyer with non-substantive questions at any time prior to the bid opening.

D. An oral statement by TSS OSP will not be part of any contract resulting from this solicitation and may not reasonably be relied on by any Prospective Contractor as an aid to interpretation unless it is reduced to writing and expressly adopted by TSS OSP.

1.4 DEFINITION OF TERMS

A. Unless otherwise defined herein, all terms defined in Arkansas Procurement Law have the same meaning herein.

B. “Business Day” means a day occurring Monday through Friday excluding State holidays as listed on the Arkansas Secretary of State’s website at https://www.sos.arkansas.gov/news/state-holiday-calendar/.

C. The terms “Invitation for Bid,” “IFB,” and “Solicitation” are used synonymously in this document.

https://arkansas-gov.zoom.us/j/82059056022?pwd=L0dxWTNPTXZnaHk0aEppZm1Qd3FsUT09 https://arkansas-gov.zoom.us/j/82059056022?pwd=L0dxWTNPTXZnaHk0aEppZm1Qd3FsUT09 https://www.sos.arkansas.gov/news/state-holiday-calendar/ https://www.sos.arkansas.gov/news/state-holiday-calendar/

D. “Prospective Contractor” means a responsible bidder who submits a Responsive Bid in response to this solicitation.

E. “Requirement” means something required.

F. “Responsive Bid” means a bid submitted in response to this solicitation that conforms in all material respects to this IFB.

G. “Shall” and “Must” mean the imperative and are used to identify requirements.

H. “Specification” means any technical or purchase description or other description of the physical or functional characteristics, or of the nature, of a commodity or service. “Specification” may include a description of any requirement for inspecting, testing, or preparing a commodity or service for delivery.

I. “State” means the State of Arkansas. When the term “State” is used herein to reference any obligation of the State under a contract that results from this solicitation, that obligation is limited to the Department using such a contract.

1.5 CURRENT ENVIRONMENT

Medicare Part D Retiree Drug Subsidy services are presently being provided for over 500 retirees and eligible spouses, and over 50 disabled members, including those diagnosed with End Stage Renal Disease (ESRD). ASP expects a minimum of 101 retired members and spouses to reach Medicare age by the end of calendar year 2022. Currently, ASP is under contract with Part D Advisors to provide these services. See Attachment A: ASP Claims History for claims history for calendar year 2020.

1.6 CONTINGENCY FEE

A. The Contractor shall provide Medicare Part D Retiree Drug Subsidy (RDS) services on a contingency fee basis.

1. The contingency fee percentage bid by the Contractor in Table 1 on the Official Bid Price Sheet must be multiplied by the Part D Subsidy Recovery to determine Contractor’s monthly payment.

B. Increases to the contingency fee percentage shall not be allowed during the initial term of the contract or during the first renewal period, if exercised.

C. Should ASP elect to exercise the remaining renewal options, (i.e., the 2nd - 6th renewal options), an increase to the contingency fee will be considered at the time of extension, if the Contractor can prove the increase is necessary and is based on an increase in market price.

1. Increases shall not be considered to increase profit or margins.

2. The Contractor shall make the request in writing, and appropriate documentation must be supplied to support the request.

1.7 MINIMUM QUALIFICATIONS

A. The Prospective Contractor shall have minimum of five (5) years’ experience working with Medicare

Part D Retiree Subsidy.

B. Prior to contract award, the Prospective Contractor shall complete and sign the Business Associate Agreement (see Attachment B: BAA).

1.8 ADMINISTRATION REQUIREMENTS AND PROCESS

A. The Contractor shall comply with all applicable State and federal laws, rules, and regulations related to providing Medicare Part D and Subsidy Services.

B. The Contractor shall comply with all Centers for Medicare and Medicaid Services (CMS) Retiree Drug Subsidy (RDS) requirements and deadlines relating to services provided under the scope of this contract.

C. The Contractor shall identify the number of Unique Benefit Options (UBOIs) within a Group Health Plan (GHP).

D. The Contractor shall identify Retire Medicare Eligible Individuals (RMEIs) and update eligibility annually.

E. The Contractor shall provide actuary for Gross and Net Test Attestations.

F. The Contractor shall obtain eligibility from ASP and shall obtain Medicare and claims data from ASP’s Pharmacy Benefit Manager (PBM).

G. The Contractor shall complete the following steps:

1. Verify monthly individual eligibility and claims data from Medicare.

2. Complete twelve (12) month eligibility and claims data for final reconciliation.

3. Monitor eligibility and claims data for final reconciliation.

4. Receive from CMS weekly eligibility updates and incorporate in format approved by CMS.

5. Monitor and comply with Retiree Drug Subsidy RDS requirements and deadlines (see Attachment C: RDS Application Deadlines and Attachment D: RDS Reconciliation Deadlines).

H. The Contractor shall work cooperatively with the ASP’s PBM.

1. The current PBM is MedImpact.

1.9 IMPLEMENTATION AND ACCOUNT SETUP ON RDS WEBSITE FOR PROCESSING SUBSIDIES

A. The Contractor shall be responsible for implementation. All implementation cost shall be treated as a one-time fee. Implementation cost must be disclosed in Table 1 on the Official Solicitation Price Sheet.

B. The Contractor shall establish an implementation plan that must ensure Medicare Part D Retiree Drug Subsidy services are fully in service by July 1, 2022.

C. The Contractor shall register with Group Health Plan (GHP) and plan sponsor with RDS.

D. The Contractor shall provide an Account Manager (AM) to oversee and assist with application and subsidy.

E. The Contractor shall provide an Authorized Representative (AR), an Actuary, and Designees.

F. The Contractor shall register as cost reporter (CR) with RDS.

G. The Contractor shall register as payment requester (PR) with RDS.

H. The Contractor shall aggregate monthly data.

I. The Contractor shall coordinate with ASP’s current PBM for prescription drug claims data.

1.10 INITIAL APPLICATIONS

A. The AM shall complete sections 1-3, 5-7, and 9 of the RDS application.

B. The AM shall upload retiree census data to RDS website.

C. The AM shall coordinate with and shall assume cost of attestation of the actuary to complete section 4 of the RDS application.

D. The AM shall review the RDS application and submit to the GHP for review, approval, and signature of the application.

E. The AM shall complete RDS required forms and shall submit to RDS for the annual renewal process on behalf of the GHP in compliance to RDS deadlines.

1.11 PAYMENT REQUEST ACTIVITIES FOR EACH MONTH (ACTUAL CLAIMS)

A. The Contractor shall complete payment setup on behalf of the GHP.

B. The Contractor shall review monthly claim information (individual claims) on a monthly basis.

C. The Contractor shall adjust claims and filter for Non-Part D Drugs.

D. The Contractor shall adjust claims for estimated rebates.

E. The Contractor shall calculate subsidy amount for each RMEI.

F. The Contractor shall calculate subsidy amount in the aggregate for all RMEIs.

G. As the PR, Contractor shall submit subsidy payment request with Updated Eligibility every thirty (30) days.

H. As the CR or PR, Contractor shall process RDS denials, inquires, and responses.

1.12 COMPLETE ANNUAL RECONCILIATION 12-STEP PROCESS

A. The Contractor shall finalize covered retirees for the reconciliation of previous year for possible additional subsidies.

B. The Contractor shall manage final cost reports and compile final rebate data.

C. The Contractor shall finalize reconciliation payment request.

D. AR shall review reconciliation payment and submit to the GHP for review, approval, and signature of the reconciliation payment.

E. AR shall monitor and comply with Retiree Drug Subsidy RDS requirements and deadlines (see Attachment C: RDS Application Deadlines and Attachment D: RDS Reconciliation Deadlines).

1.13 REOPENING OF PREVIOUSLY RECONCILED FILINGS OF THE RDS

A. The Contractor shall complete documentation and gathered data and shall apply within four (4) years of original reconciliation date.

B. The Contractor shall review data for any incomplete information and inaccuracies.

C. The Contractor shall generate new cost report to RDS in conformance RDS guidelines.

D. The Contractor shall submit appeal requests to RDS in conformance RDS guidelines.

E. The Contractor shall complete the reopening.

F. The Contractor shall resubmit final reconciliation to RDS in conformance RDS guidelines.

G. The Contractor shall submit payment justification to RDS in conformance RDS guidelines.

H. The Contractor shall monitor and comply with Retiree Drug Subsidy RDS requirements and deadlines (see Attachment C: RDS Application Deadlines and Attachment D: RDS Reconciliation Deadlines).

1.14 COMMUNICATION

A. The Contractor shall monitor impact of RDS and CMS announcements to GHP.

B. The Contractor shall notify ASP of any requirements, deadlines, and documentation needed from the GHP within ten (10) Business Days in advance of the deadline.

1.15 REPORTING

A. The Contractor shall provide actuarial services for attestation.

B. The Contractor shall provide an eligibility report to ASP on annual basis. The report must be submitted by each December and must be submitted in Excel format via secure email.

C. The Contractor must submit reports to ASP no later than thirty (30) days following the close of the previous month.

D. The Contractor shall provide requested documentation and information to ASP no later than seven

(7) calendar days from the date of the request unless an extension has been requested and mutually agreed upon prior to the due date.

1.16 DATA SECURITY

A. The Contractor shall maintain electronic and physical security of all data to include on and off-site backups.

B. The Contractor shall comply with all rules and regulations concerning Protected Health Information (PHI) and the storage, transmission, and destruction of data.

C. The Contractor shall complete an annual SOC 1 Type II report specifically designed to test the policies, procedures, and general IT security of their services.

D. The Contractor shall complete annual penetration tests on their network and facilities.

E. The Contractor shall use an offsite data warehouse to securely house all client data. This facility must be hardened, secure, and complete annual SOC reports and Pen tests.

F. The Contractor shall complete annual Health Insurance Portability and Accountability Act of 1996 (HIPAA) testing, phishing training, and general IT security training.

G. The Contractor shall utilize Data Loss Prevention software and monitoring.

H. The Contract shall have Intrusion Prevention Systems (IPS) and Intrusion Detection Systems (IDS) in place.

I. The Contractor shall have 24/7 IT monitoring from a company specializing in stopping ransomware attacks and prevents data breaches.

1.17 DATA RECORDS

A. The Contractor shall retain all applications and payment requests for a period of six (6) years following the filing date.

B. The Contractor shall retain all actuarial reports/studies for a period of six (6) years following the processing date.

C. The Contractor shall assist with all audits as requested by ASP.

D. The Contractor shall provide data in a secure auditable format mutually agreed to by the Contractor and ASP, with the final determination made by ASP.

E. The Contractor shall retain records in secure electronic format.

F. The Contractor shall provide at no charge to ASP, all records, documentation, reports, data, recommendations, and/or printing elements, etc., produced under a resulting contract to ASP or to ASP’s designee, within seven (7) days of ASP’s request, contract termination, or contract cancellation.

1. The Contractor shall follow the method of delivery determined by PECD.

2. This Requirement does not refer to the Contractor’s intellectual property.

1.18 CONTRACTOR ACCOUNT MANAGEMENT

A. The Contractor shall comply with mutually agreed upon deadlines, benchmarks, and timelines established by CMS for any reconciliation or applications submitted by the Contractor on behalf of

ASP.

B. The Contractor shall comply with the Business Associate Agreement (see Attachment B: BAA).

1.19 FINANCIAL ACCURACY

The Contractor must comply with the accepted standard subsidy calculation which is 28% of the Allowable Retiree Costs less a 2% reduction.

1.20 CONTRACTOR SELF-AUDITS

A. The Contractor shall conduct monthly self-audits of each of the performance standards as listed in

Table 1: Performance Standards.

B. The Contractor shall provide an audit report to ASP each month. The audit must encompass a statistically valid random stratified sampling of ASP items selected.

C. Monthly audit(s) shall be completed within thirty (30) days following the period to which the audit pertains and shall be the basis on which any fee adjustments are made.

D. All applicable fee adjustments shall be applied within thirty (30) days following completion of the Contractor’s monthly self-audit, unless otherwise noted.

1.21 CONTRACTOR RESPONSIBILITY UPON TERMINATION OF CONTRACT

A. In the event the resulting contract should be terminated, cancelled, or should expire, the Contractor shall assist ASP and the new Contractor, to the extent ASP determines necessary, to ensure an orderly transfer of responsibility and the continuity of those services required under the terms of the contract to another organization designated by ASP.

B. The Contractor shall provide all services to execute the successful transition of services data.

1. Except as specifically agreed to by ASP, it is anticipated that ASP’s main role will be supervisory to ensure that all of ASP’s needs are sufficiently and successfully met.

C. All data, records, files, and other information relating to the ASP account must remain the property of ASP and must be released to ASP in the event the contract is ended.

1.22 DISASTER RECOVERY

A. The Contractor shall have in place a comprehensive emergency operation, disaster recovery, and business continuity plan throughout the aggregate term of a resulting contract.

B. The Contractor shall provide the emergency operation, disaster recovery, and business continuity plan to ASP within three (3) Business Days of ASP’s request.

1.23 ADDITIONAL SERVICES

A. Throughout the term of this contract, as requested by ASP or as required by law, ASP may choose to add or remove any services offered by the Contractor under the scope this contract. These services may be existing services as offered in the Contractor’s bid, or they may be newly created services based on improving technology or may be required as a result of newly enacted Federal and/or State mandates. Pricing for these services shall be negotiated if/when the services are added or removed;

shall be consistent with current contract pricing for similar services; and shall be agreed upon in writing between agency and Contractor prior to implementation of the service.

B. The Contractor should include pricing in Table 2 on the Official Solicitation Price Sheet for any additional services currently offered relating to the annual RDS application process that are not requirements of this IFB. The cost of items listed in Table 2 will not be used in low-cost evaluation.

Do not include the cost for these additional services in Table 1 of the Official Solicitation Price Sheet.

1.24 ACCEPTANCE STANDARDS

A. Inspection and acceptance/rejection of product(s) will be made within thirty (30) days of receipt.

B. The State has the option to return any product(s) within the thirty (30) day timeframe for any reason.

C. Bid must include a “total satisfaction” return policy for all products and must not impose any liability on the State for such returns.

1.25 PERFORMANCE STANDARDS

A. State law requires that contracts for services include Performance Standards for measuring the overall quality of services that a Contractor shall provide.

B. The State may be open to negotiations of Performance Standards prior to contract award, prior to the commencement of services, or at times throughout the contract duration. Table 1: Performance Standards identifies expected deliverables, performance measures, or outcomes; and defines the acceptable standards.

C. Performance Standards shall not be amended unless they are agreed to in writing and signed by the parties.

D. Failure to meet the minimum Performance Standards as specified will result in the assessment of damages.

E. In the event a Performance Standard is not met, the Contractor will have the opportunity to defend or respond to the insufficiency. The State has the right to waive damages if it determines there were extenuating factors beyond the control of the Contractor that hindered the performance of services. In these instances, the State has final determination of the performance acceptability.

F. Should any compensation be owed to the Department due to the assessment of damages, Contractor shall follow the direction of the Department regarding the required compensation process.

Table 1: Performance Standards

Service Criteria Acceptable Performance Damages for Insufficient

Performance

Implementation

Comply with all deadlines, benchmarks, and timelines established by the CMS and coordinate with the ASP’s current Contractor for all reconciliations or applications currently pending for ASP. Coordinate with ASP’s current PBM for prescription drug claims data

1% of the total implementation cost for each calendar day beyond the specified date whereby the Contractor fails to complete all implementation activities

Account Management

Comply with deadlines, benchmarks, and timelines established by the CMS for any reconciliations or applications submitted by the vendor on behalf of ASP

3% of the total monthly invoice for each instance whereby the Contractor fails to comply with the established deadlines, benchmarks, and timelines

Reporting Comply with deadlines for reports and documentation as required by the IFB deadlines and other stated deadlines by ASP

$100 for each calendar day beyond the deadline whereby the Contractor fails to provide the required reports and/or documentation

SECTION 2 – GENERAL INSTRUCTIONS AND INFORMATION

• Do not provide responses to items in this section unless specifically and expressly required.

2.1 TYPE OF CONTRACT

A. As a result of this IFB, TSS OSP intends to award a contract to a single Contractor.

B. The anticipated starting date for any resulting contract is July 1, 2022, except that the actual contract start date may be adjusted unilaterally by the State for up to three (3) calendar months. By submitting a signed bid in response to the IFB, the Prospective Contractor represents and warrants that it will honor its bid as being held open as irrevocable for this period.

C. The initial term of a resulting contract will be for one (1) year. Upon mutual agreement by the Contractor and Department, the contract may be renewed by TSS OSP for up to six (6) additional one-year terms or portions thereof, not to exceed a total aggregate contract term of seven (7) consecutive years.

2.2 CONTRACTOR SELECTION

Award will be made to the lowest-bidding, responsible Prospective Contractor.

2.3 RESPONSE DOCUMENTS

A. All bid responses must be submitted through ARBuy, the State’s eProcurement system. The system can be accessed at https://arbuy.arkansas.gov.

B. Bid Response Packet, which must be in the English language

1. The following are bid submission requirements and must be submitted as part of a Prospective Contractor’s bid response.

a. Signed Bid Signature Page. Signature may be ink or digital. (See Bid Response Packet.)

b. Proposed Subcontractors Form. The utilization of any proposed subcontractor is subject to approval by the Department.

c. Exceptions Form.

d. Completed Pricing Response.

i. Prospective Contractors shall complete the Official Bid Price Sheet attached to solicitation posting in ARBuy as specified on the Instructions tab of the Official Bid Price Sheet.

ii. Pricing must be proposed in U.S. dollars and cents.

e. Copy of Prospective Contractor’s Equal Opportunity Policy.

2. The following items, which must be submitted prior to a contract award to the Prospective Contractor, may also be included with the Prospective Contractor’s bid response:

a. EO 98-04 Contract & Grant Disclosure Form.

b. Voluntary Product Accessibility Template (VPAT), if applicable.

3. DO NOT include any other documents or ancillary information, such as a cover letter or promotional/marketing information.

2.4 ACCEPTANCE OF REQUIREMENTS

A. Unless a Prospective Contractor expressly and conspicuously identifies any exception or exceptions to any of the Requirements in the Requirements Section(s) of this IFB by listing them on the Exceptions Form (see Bid Response Packet), Prospective Contractor understands and agrees its submission of a bid to represent that its bid meets all such Requirements.

https://arbuy.arkansas.gov/

B. A Prospective Contractor’s bid may be rejected if the Prospective Contractor takes exception to any Requirements in the Requirements Section(s) of this IFB.

2.5 ADDITIONAL TERMS AND CONDITIONS

A. This IFB incorporates all of the Solicitation Terms and Conditions located on the TSS OSP website found at transform.ar.gov.

B. Any special terms and conditions included in this solicitation shall override the Solicitation Terms and Conditions.

C. Unless a Prospective Contractor expressly and conspicuously identifies any exception or exceptions to any of the terms in the Services Contract (SRV-1) Fillable Form by listing them on the Exceptions Form (see Technical Proposal Packet), Prospective Contractor agrees and shall adhere to all terms if selected as the successful Contractor.

1. Items identified as non-negotiable may only be modified if the legal requirement is satisfied and approved by the State.

2. The Standard Commodities Contract can be viewed on the TSS OSP website here. The Services Contract (SRV-1) Fillable Form can be viewed on the TSS OSP website here

D. A Prospective Contractor’s bid may be rejected if a Prospective Contractor takes exception to any terms or conditions in the documents listed in this subsection.

https://www.transform.ar.gov/wp-content/uploads/2021/12/MASTER-Solicitation-Terms-and-Conditions-11-29-21.pdf https://www.transform.ar.gov/wp-content/uploads/2020/06/Standard-Commodities-Contract-Template-6.18.20.docx https://www.transform.ar.gov/wp-content/uploads/2021/08/Services-Contract-SRV-1-Fillable-Form-V.2.pdf