Statement of Proprietary Information_Alivia - 122125.docx

The document is a Statement of Proprietary Information for Request for Proposal (RFP) Number 122125 issued by the Nebraska Department of Health and Human Services (DHHS) for a Program Integrity Case Management system. The RFP seeks a comprehensive cloud-based Software as a Service (SaaS) solution to replace the current Medicaid program case management system, with capabilities for fraud detection, advanced analytics, and predictive modeling. The solicitation was released on May 28, 2025, with proposal responses due by July 10, 2025, at 2:00 p.m. Central Time, and an expected implementation date no later than October 31, 2026. The contract will have an initial five-year term with options to renew for two additional two-year periods.

The proposed system must integrate with existing state systems, including the Medicaid Management Information System (MMIS) and the Nebraska Family Online Client User System (N-FOCUS), and meet stringent security requirements including TLS encryption, AES-256 data protection, and HIPAA compliance. Evaluation will be conducted across three categories: Corporate Overview (25 points), Technical Response (60 points), and Cost Sheet (15 points), with a potential total of 100-120 points. The project is eligible for enhanced federal financial participation (FFP), and the vendor will be responsible for supporting CMS certification, data migration, training, and ongoing maintenance. Mandatory vendor qualifications include having a current implemented Program Integrity Case Management and Fraud Analysis & Detection System contract with another State Medicaid agency.