Actuarial Services and Medicaid Projects

The Texas Health and Human Services Commission (HHSC) has issued a Request for Proposals (RFP) No. HHS0014046 for Actuarial Services and Medicaid Projects, seeking a single contractor to provide comprehensive actuarial support for Medicaid and Children's Healthcare Insurance Program (CHIP) services. The RFP requires a contractor with expertise in data management, analysis, policy research, stakeholder engagement, and support for directed payment programs and quality-based payment strategies. Key qualifications include having at least one senior actuary who is a Member of the American Academy of Actuaries (MAAA) and a Fellow of the Society of Actuaries, with demonstrated experience in Medicaid and CHIP managed care delivery systems. The solicitation was released on April 17, 2024, with proposals due by May 16, 2024, at 10:30 a.m. Central Time, and a pre-proposal conference and HSP Training scheduled virtually on April 23, 2024. Contractors will be evaluated based on their technical capabilities, proposed approach, and ability to meet the specific requirements outlined in the RFP. The initial contract term will be three years, with HHSC having the option to extend the contract for up to two additional years.

The RFP includes a Historically Underutilized Business (HUB) subcontracting goal of 26%, emphasizing the importance of good faith efforts in promoting diversity and inclusion in the procurement process. Contractors must submit a HUB Subcontracting Plan and can propose additional labor categories as exceptions through the designated Exhibit G. The total compensation for the contract is not to exceed $15 million for the entire contract term, with historical compensation around $1 million per fiscal year. Compensation will be based on Work Orders with pricing structures including lump sum, fixed fee, or time and materials, with reimbursement upon acceptance of deliverables. While specific details about incumbent providers are not disclosed, the contract will require contractors to work directly with HHSC's Medicaid and CHIP Services, Delivery System and Quality Innovation team. The procurement allows for multiple submission methods, including an online bid room, and emphasizes that work orders will be evaluated using consistent criteria. Notably, HHSC makes no guarantee of volume, usage, or total compensation, and the contract is subject to appropriations and continuing availability of funds.