Statement of Proprietary Information_Deloitte - 122125.docx

This document is a Statement of Proprietary Information from Deloitte related to Request for Proposal Number 122125 for the State of Nebraska's Department of Health and Human Services (DHHS). The proposal seeks a comprehensive Program Integrity Case Management (PICM) and Fraud Analysis & Detection System to replace the current Medicaid program case management system. The solicitation was released on May 28, 2025, with proposal responses due by July 10, 2025, at 2:00 p.m. Central Time. The project aims to implement a cloud-based, modular Software as a Service (SaaS) platform by October 31, 2026, with capabilities for tracking recoupments, identifying billing practice outliers, conducting retrospective drug utilization reviews, and referring suspected provider fraud cases. The contract will have an initial five-year term with options to renew for two additional two-year periods.

The procurement requires mandatory vendor qualifications, including a current implemented PICM/FADS contract with another State Medicaid agency. Evaluation criteria will assess responses across three categories: Corporate Overview (25 points), Technical Response (60 points), and Cost Sheet (15 points), totaling 100-120 points potentially including oral interviews. The solution must integrate with existing state systems like the Medicaid Management Information System (MMIS) and Nebraska Family Online Client User System (N-FOCUS). Security requirements include TLS encryption, AES-256 data protection, role-based access control, and HIPAA compliance. The project is eligible for enhanced federal financial participation, and the vendor will support CMS certification process, data migration, training, and ongoing maintenance. The state will allocate up to 500 vendor hours annually for system modifications at no additional cost.