CCBHC Comprehensive PPS Rate Methodology & Development

The South Dakota Department of Social Services (DSS), Division of Behavioral Health is seeking a qualified vendor to provide comprehensive cost analysis and prospective payment systems (PPS) evaluation services for a Certified Community Behavioral Health Center (CCBHC) planning grant. The primary objectives include developing a comprehensive rate methodology, evaluating PPS options, and producing a detailed final report with an executive summary, methodology findings, rate model recommendations, fiscal impact analysis, and stakeholder engagement summary. Key deliverables will require the vendor to demonstrate expertise in analyzing cost and utilization data, developing rate calculations, and ensuring compliance with federal Centers for Medicare & Medicaid Services (CMS) guidelines and South Dakota Medicaid policies. The project is scheduled to initiate on November 1, 2025, with primary deliverables to be completed by December 31, 2025, and proposals due no later than October 22, 2025. Proposal evaluation will be based on specialized expertise, technical competence, project management techniques, proposed approach, and cost. Potential contract extension is possible through May 31, 2026, contingent on continued funding. Interested vendors must submit inquiries via email to Kirsten.Blachford@state.sd.us with the subject line "RFP17383" by the specified deadline.

The RFP does not explicitly mention specific set-aside designations or restrictions on responding organizations. The vendor will be required to provide two potential sustainability paths for future rate setting reviews: one strategy that can be transferred to the state and another vendor-led review option. While a specific contract amount is not definitively stated, the document indicates the total contract value will be negotiated and will not exceed a predetermined budget. The state reserves the right to negotiate contract terms and may award the contract to the highest-ranked offeror after discussions and refinement of the scope of services. The project is funded through a planning grant, suggesting potential flexibility in contract structure and funding. Vendors will need to demonstrate sophisticated understanding of behavioral health cost analysis, rate methodology development, and comprehensive knowledge of CMS and state Medicaid policy frameworks to be competitive in this procurement opportunity.