Federally Qualified Health Center & Rural Health Clinic Services Rate

The South Dakota Department of Social Services (DSS), Division of Medical Services is seeking a qualified vendor to conduct a comprehensive rate study for Federally Qualified Health Centers (FQHCs) and Rural Health Clinics. The project involves analyzing current reimbursement policies, developing recommendations for alternative payment models, and creating value-based payment strategies that incentivize high-quality, cost-effective care. The vendor will be responsible for gathering data from approximately 50 FQHCs across 4 systems and 78 Rural Health Clinics, performing detailed research and cost analysis, developing rate models with fiscal impact assessments, and facilitating stakeholder engagement through workgroup meetings. Key deliverables include a final report due by August 31, 2025, with new rates expected to be effective July 1, 2026. Proposals are due February 14, 2025, at 5:00 PM CDT, with an anticipated award date of February 27, 2025, and a project kick-off meeting required no later than April 1, 2025. The contract term is one year, ending May 31, 2025, with no renewal options. Evaluation criteria will be weighted from most to least important, focusing on the scope of work requirements.

The RFP does not specify any specific set-aside designations or restrictions on vendor participation. There is no listed incumbent vendor, with the last rate study conducted in 2000. Vendors must maintain professional liability insurance of at least $1 million and other standard insurance coverages, including commercial general liability, business automobile liability, and worker's compensation insurance. The state has not established a specific budget for the project and expects vendors to include all expenses in their proposals, covering hourly rates, fees, and travel costs. Proposals must be submitted as PDFs via Secured File Transfer Protocol (SFTP), with vendors required to request an SFTP folder from the state contact. While subcontracting is possible, it requires prior written state consent, and the primary work must be completed in-house with proper security protocols. The state reserves the right to require oral presentations and negotiate with offerors, though awards may be made based on initial proposals without further discussion.