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Independent Verification and Validation (IV&V) forMedicaid Eligibility and Health Information Services

Request for Proposals # 529-09-0062Vendor Conference April 21, 2009

Welcome

• Introductions by Thomas Spears– Thomas Spears, Enterprise Contract and Procurement

Services (ECPS)– Noel Villarreal, EHI Director– Carlos Balderas, HUB Administrator, Administrative Services

Development (ASD)– Elizabeth LaMair, HHSC Assistant General Counsel

• Housekeeping Items

HHSC Procurement Roles

• ECPS– Responsible for procurement activity

• HUB– Responsible for Historically Underutilized Business (HUB) activity

• Program– Responsible for project scope, requirements, performance, results,

contract management/monitoring• Legal

– Questions/answers and legal observations

Vendor Conference Overview

• Procurement Activities• RFP Overview• HUB Requirements• Vendor Questions Submittal• Break• Preliminary Responses to Questions• Closing Comments

Procurement Activities

• Sole Contact, Thomas Spears, ECPS• Procurement Schedule • Solicitation Access-

http://www.hhsc.state.tx.us/about_hhsc/BusOpp/contracts.asp• Submission Requirements• Solicitation Changes (Addendums)• Screening & Evaluation• Award Information

HHSC Point of Contact

Thomas Spears, Contract AdministratorEnterprise Contract and Procurement Services (ECPS) Division4405 N. Lamar Blvd. Austin, Texas 78756-3422(512) 206-5769 Fax (512) [email protected]

All communications relating to this RFP must be directed to the HHSC contact person. All communications between respondents and other HHSC staff members concerning this RFP are strictly prohibited. Failure to comply with these requirements may result in proposal disqualification.

Schedule

PROCUREMENT SCHEDULE

RFP Release Date April 3, 2009

Vendor Conference April 21, 2009

Vendor Questions Due April 22, 2009

HHSC Posts Responses to Vendor Questions April 30, 2009

Proposals Due May 14, 2009

Anticipated Contract Start Date August 1, 2009

RFP OVERVIEW

Noel Villarreal, EHI Project Director Medicaid/CHIP Division

EHI Background

• Current Environment– HHSC mails approximately 2.7 million paper Med ID letters each month– Over 1 million letters are returned annually– Requires full-time staff to process– Current tools and processes support relatively static data model– Lives of the clients are dynamic, and so is the data– Access to data is limited

• Key Mission Elements for the EHI Project:– Replace the paper Med ID form with a permanent plastic card– Introduce an electronic health record system

• Key Goals for EHI Project:– Improve communication with clients and providers– Improve access and quality of information available to providers beyond what is available on the printed

paper form– Provide more on-demand information and self-service capability to clients– Provide multiple channels for access to information (i.e. call centers, web, interfaces)– For EHI Project, see Medicaid Eligibility Health Information RFP# 529-08-0128 at:

http://www.hhsc.state.tx.us/Contract/529080128/rfp_home.html

IV&V Mission

• The primary objective for this procurement is to assist HHSC in administering the Medicaid EHI Services contract by:

– Assuring the accurate, complete and timely delivery of services;– Monitoring and reporting on the Medicaid EHI Services vendor performance,

specifically related to quality, risk management and issues resolution; – Exploring opportunities to maximize efficiency and reduce costs in the

administration of the affected State programs;– Offering recommendations and possible alternatives to HHSC for the Vendor to

achieve the goals and objectives of the Medicaid EHI project; and– Strategic planning support.

Scope

• In summary, the Vendor must provide the following high-level functions:

– Implementation Support

– Operational Support

– Strategic Planning Support

Scope of Work: Specific Tasks

• Implementation Support:– Validate EHI Vendor’s Management Plans– Monitoring and Evaluation of EHI Services Design and Planning – Support of Acceptance Testing– Confirm System Readiness Status– Support Initiation of EHI Operations – Confirmation of Readiness for Provider Services Automation Option

Deployment– Monitor Status of Initial EHI Card Issuance– Evaluation of Performance Targets for Full Operations– 60-day Review To Confirm System Defects Resolved


• Operational Support– Verification of Deliverables– Site Reviews– Performance Reporting (Baseline and Monthly Reports)– Contract Compliance Monitoring– Technical Support– Financial Management Support– Quality Assurance and Monitoring


• Strategic Planning Support– Project Management– Communications– Transition– Planning

Turnover

• Turnover requirements:– At the end of the Contract, the Vendor will transfer ownership and possession of

all hardware, software, data purchased or developed under the Contract and any other materials or property deemed to be a product of the project to HHSC.

– The Vendor will be responsible for all costs related to transferring these assets to HHSC. All transferred data must be compliant with HIPAA requirements.

– The Vendor must provide HHSC with copies of all relevant data, documentation, or other pertinent information necessary, as determined by HHSC, for HHSC or a subsequent vendor to assume the Contract activities successfully.

– The Vendor must describe in the Turnover Plan their approach and schedule for transfer of all hardware, software, data, services, and operational support information, as applicable.

Performance Measures

• HHSC will monitor the performance all services and deliverables under the Contract and services must be provided at an acceptable quality level.

• The Vendor must perform its responsibilities and tasks as specified in the Contract. Vendor must also address the majority of the project "risks" related to its performance as provided in the Contract.

• If the Vendor fails to meet the contract requirements, HHSC will assess liquidated damages (LDs) as specified per incident.

• The purpose of establishing and imposing LDs is to provide a means for HHSC to: (1) obtain the services and level of performance required for successful operation of this Contract; (2) ensure Vendor commitment to resolve project “risks” or otherwise endure consequences.

Financial Requirements

• Payment is strictly conditioned on HHSC approval and acceptance of the Vendor services and deliverables.

• All expenses (including travel and travel-related expenses) incurred by the Vendor will be the sole responsibility of, and paid by, the Vendor. Such expenses will not be reimbursed by HHSC.

• Invoices will be submitted to HHSC Medicaid/CHIP Contract Management with a detailed breakdown of all services and deliverables.

• Respondents must complete Appendix C and D and submit along with the cost proposal.

Financial Accounting & Reporting

• The Vendor’s accounting records and supporting information related to all aspects of the Contract must be accumulated in accordance with Generally Accepted Accounting Principles (GAAP).

• Vendor must maintain accounting records for the IV&V Program separate and apart from other corporate accounting records;

• Vendor must maintain an accounting system that provides an audit trail containing sufficient financial documentation to allow for the reconciliation of billings, reports, and financial statements with all general ledger accounts; and

• Vendor must pay for all reasonable costs incurred by HHSC to perform an examination, review or audit of the Vendor’s books pertaining to the Contract. (i.e. Financial Audits, Risk Assessments, Operations/Performance Audits, and other relevant financial and accounting processes as determined by HHSC).

HUB Subcontracting Plan(HSP) Requirements

Carlos Balderas, HUB Administrator, Administrative Services Development

Agenda TopicsAgenda Topics

• RFP Section 4.0 Historically Underutilized Business RFP Section 4.0 Historically Underutilized Business

Participation RequirementsParticipation Requirements

• HUB Subcontracting Plan for the RFP is requiredHUB Subcontracting Plan for the RFP is required

• Self Performance HSP Self Performance HSP

• HSP Prime Contractor Progress Assessment ReportHSP Prime Contractor Progress Assessment Report

• HUB Participation GoalsHUB Participation Goals

• Potential Subcontracting OpportunitiesPotential Subcontracting Opportunities

• Vendor Intends to Subcontract Vendor Intends to Subcontract

• Minority or Women Trade Organizations Minority or Women Trade Organizations

• Self PerformanceSelf Performance

• HSP Changes After Contract AwardHSP Changes After Contract Award

• Reporting and Compliance with the HSPReporting and Compliance with the HSP

RFP Section 4.0 - Historically Underutilized Business RFP Section 4.0 - Historically Underutilized Business

Participation RequirementsParticipation Requirements

If HSP is inadequate, response will be rejected

HSP Information Page


HUB GOALS

Special reminders and instructions

Company Information

If more than 20 subcontracting

opportunities, click the link provided to

continue adding


Enter subcontracting opportunities

Subcontracting

Declaration

One page for each area

subcontracted(listed on page

1)


List Line # and Subcontracting Opportunity


Protégé performing the

work


Skip to Sections

8 and 10

Professional Services Category


Good Faith Efforts to

find/include Texas Certified HUB Vendors


Contact HUB Trade

Organization


Written Notification

Requirements


List 3 HUBs Contacted

for this Subcontractin

g Opportunity


List Subs Selected (HUBs & Non-HUBs)

for this Subcontracting

Opportunity


Reason why HUB was not selected

for this Subcontracting

Opportunity


Self Performanc

e Explanation


Signature Affirms that

True and Correct

Information is Provided

• Required with ALL Pay Requests

• List ALL Sub payments (HUBs & Non-HUBs)

HSP Prime Contractor Progress Assessment Report

ATTACHMENT “E”

HSP ASSISTANCE FROM TPASS

HUB Subcontracting Plan (HSP) Forms

Step-by-step instructions and an audio on “How to Complete an HSP ” is located on the Comptroller of Public Accounts (CPA) Texas Procurement and Support Services (TPASS) website at:

http://www.cpa.state.tx.us/procurement/prog/hub/hub-forms/

HUB Subcontracting Plan Instructional Video

Play Windows Media Version (7.7 MB download)

Play Quicktime (mp4) version (24 MB download)

Play Macromedia Flash version (10.8 MB download)

Read Video Transcript (.rtf file) (160 K download)

http://www.cpa.state.tx.us/procurement/prog/hub/hub-forms/

http://www.cpa.state.tx.us/procurement/prog/hub/hub-forms/hsp_project.wmv

http://www.cpa.state.tx.us/procurement/prog/hub/hub-forms/hsp_project.mp4

http://www.cpa.state.tx.us/procurement/prog/hub/hub-forms/hsp_project.swf

http://www.cpa.state.tx.us/procurement/prog/hub/hub-forms/hsp_project.rtf

Administrative Services Administrative Services Development HUB Program Development HUB Program

OfficeOfficeRobert L. Hall, C.P.M.Robert L. Hall, C.P.M.

Director of Administrative Services DevelopmentDirector of Administrative Services Development- (512) 424-6596- (512) 424-6596- - [email protected]@hhsc.state.tx.us

Carlos A. BalderasCarlos A. Balderas ASD HUB AdministratorASD HUB Administrator

- (512) 424-6896- (512) 424-6896- - [email protected]@hhsc.state.tx.us

Sherice Williams-PattySherice Williams-Patty ASD HUB AdministratorASD HUB Administrator


Sharon AddisonSharon Addison ASD Procurement/HUB Team LeadASD Procurement/HUB Team Lead


mailto:[email protected]




Legal Overview

Elizabeth LaMair,Office of General Counsel

• Collusion

• Conflict of Interest

• Permissible Contacts

• RFP Requirements

Questions & Answers

• Questions Submittal• Followed by Break

Preliminary Responses

• Questions and Answers– Non-binding verbal answers to vendor questions– Binding responses will be posted on the procurement website

by April 30, 2009

Closing Comments

Thomas Spears, ECPS

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