Request for Information Amendment #1

Request for Information Amendment #1

PERSONAL CARE SERVICES (PCS)

ELECTRONIC VISIT VERIFICATION SYSTEM

Release Date: May 31, 2017

Deadline for Submission and Opening Date and Time: June 23, 2017 @ 3:00 pm

Refer to Section 5, “RFI Timeline” for the complete RFI schedule

This document must be submitted

in the vendors response

Refer to Section 8, for instructions on submitting responses

Contact Information

Company Name: State of Nevada, Division of Health Care Financing and Policy

Address: 1100 E. William St. City: Carson City State: Nevada Zip: 89701

Telephone: (775) 684-3676 Fax: (775) 684-3893

E-Mail Address:

TABLE OF CONTENTS

Notice…………………………………………………………………………………… ……… 3
Purpose…………………………………………………………………………………… ….. 3
Background………………………………………………………………………… …….. 3 - 4
Response Instructions……………………………………………………………………………… .. 4 - 6
RFI Timeline…………………………………………………………………………………………. 6
Proprietary Information……………………………………………………………………………….. 6 - 7
Questions and Answers……………………………………………………………………………………… 7
Response Requirements and Submission…………………………………………………………………………………….. 7
Costs……………………………………………………………………………………………….. 8
Right to Cancel…………………………………………….……………………………………………….. 8
Acceptance of Responses…………………………………………………………...…………………………. 8
Response Not Mandatory………………………………………………………………………………..……. 8
Response Non-Binding……………………………………………………………………………………………. 8
Review of Responses………………………………………………………………………………………. 8
Subsequent Solicitations…………………………………………………………………….……………… 8
Division of Health Care Financing & Policy……………………………………………………………………………………………… 8

1. NOTICE

This solicitation is a Request for Information (RFI) for planning purposes only. A RFI is not a method of procurement, or a solicitation for quotations, bids or proposals. Responses to an RFI are not offers and shall not be accepted by the Division of Health Care Financing & Policy (DHCFP) to form a binding Contract. This RFI and responses to it shall not result in the execution of a contract with the DHCFP. By submitting a response to this RFI, a vendor is not prohibited from responding to any related subsequent solicitation.

This RFI may be used for purposes of determining whether or not to competitively procure a commodity or contractual service, determining what solicitation process to use, or researching general, special, and/or technical specifications for a solicitation. The DHCFP reserves the right to utilize the information gathered through this RFI process to develop a scope of services, which may be incorporated into a contract using a statutorily approved method of procurement.

2. PURPOSE

In December 2016, Congress passed H.R 34 – 21st Century Cures Act, mandating that all States require the use of an Electronic Visit Verification system for all Medicaid funded personal care services that are provided under a State plan or a waiver of the plan, including services provided under section 1915(c), 1915(i), 1915(j), or 1915(k) or under a wavier under section 1115, States not requiring the use of an EVV system for such services by January 1, 2019 will see a reduction in the federal funding received.

In order to comply with this recently passed federal regulation, the Division of Health Care Financing & Policy, which operates Nevada’s Medicaid program and other health benefit programs, is issuing this Request for Information (RFI) to solicit information on available EVV Systems that exist in the marketplace to verify in-home service delivery for personal care, home health care, attendant care, homemaker, chore and respite services. The EVV system must verify the following information:

the type of service performed
the individual receiving the service
the date of the service
the location of service delivery
the individual providing the service
the time the service begins and ends

Information gained from RFI responses will not only help with the implementation of an EVV system to meet the federal mandate, but will also help meet the following DHCFP objectives:

Ensure timely service delivery for recipients including real time service gap reporting and monitoring;
Reduce administrative burdens associated with hard copy timesheet processing; and
Generate cost savings from the prevention of fraud, waste and abuse.

3. BACKGROUND

Nevada’s Medicaid program pays for medical and medically-related services for persons eligible for Medicaid under Title XIX of the Social Security Act. In addition to the federally mandated Medicaid services, Nevada has opted to offer several optional services and receives federal funding to do so. Personal Care Services (PCS) is one of the several optional services offered to persons eligible for Medicaid. Nevada Medicaid also administers the Physically Disabled (PD) and the Frail Elderly (FE) Home and Community-Based Services 1915(c) Waivers, whose regulations are found in Section 1915(c) of the Act, and for which federal funding is received for personal care services.

Service reimbursement may be offered either through a fee-for-service model or under a managed care contract, or a combination of both. Nevada Medicaid administers both the fee-for-service and managed care programs. Medicaid recipients living in rural areas of the state are enrolled in the fee-for-service model. Recipients living in Southern Nevada and those living in parts of Northern Nevada choose enrollment with one of the two contracted managed care organizations, but as of July 1, 2017 will have a total of four contracted managed care organizations from which to choose.

PCS are offered to all Medicaid eligible, fee-for-service, waiver and managed care organization, individuals. Currently there are a total of 150 enrolled PCS agencies and two MCO’s that service Nevada Medicaid recipients statewide. As of July 1, 2017 there will be four MCO’s.

The following chart provides number of recipients by program type and service for State Fiscal Year (SFY) 2016:

Service Type / Fee-for-Service / PD Waiver / FE Waiver / MCO / Total Recipients
Personal Care Services / 8,822 / 250* / 9,072
Attendant Care / 282 / 282
Homemaker / 231 / 506 / 737
Chore / 27 / 30 / 57
Respite / 122 / 179 / 301

* MCO data from SFY 2015

4. RESPONSE INSTRUCTIONS

Vendors responding to this RFI are asked to be thorough, but concise and are encouraged to suggest changes and provide additional requirements that they believe would assist in the success of the project, but are not included herein. The State expects vendors to propose creative, competitive solutions to the DHCFP's stated needs. The RFI response should include, but is not limited to, the following:

 A description of the vendor’s business and its experience as it relates to the services outlined in this RFI. This description should include a narrative explaining past experiences and indicate how it delivers this type of service in similar Medicaid settings or other health care agencies or insurers, health care providers or government agencies in the area of EVV technologies.

Describe and discuss the population characteristics of individuals currently served by your system(s) (i.e. number of members, types of populations and special needs of the populations, etc.)

Discuss strategies employed to garner customer satisfaction and include any satisfaction survey data, if available.

Describe the process for the implementation of the system including work plans, timelines for implementation and training for all user populations (individuals, providers, State Medicaid Agency and MCOs). If available, provide examples of implementation whereby the vendor was an exclusive vendor in a single geographic area and/or one vendor amongst several in a geographic area.

 The vendor should include information regarding its experience and capability as it relates to this type of service.

Provide a detailed description of the EVV system. At a minimum, the description must include the following:

Functionality of the system including the devices, technology and infrastructure requirements for both individuals receiving services and service providers (e.g. cellular phones, fixed device in home, tablet, internet, GPS, other)

Security features of the system that confirms the identity of both the provider of service and individual receiving the service and replace the need for a hard copy or electronic signature

Flexibility of the system to allow for manual overrides and instances whereby manual overrides are allowed

Real time data collection and monitoring including data storage and record retention

Features of the system that address needs of special populations of both service providers and individuals receiving services (e.g. individuals with limited English proficiency, individuals with vision and/or hearing impairments, individuals with physical disabilities, individuals who are self-directing their care, etc.)

Features of the system that addresses the provision of EVV in rural areas where technology infrastructure is limited or non-existent (e.g. no internet access, no cell phones or landline telephone in home, etc.)

Contingency plans for when a system may be temporarily unavailable or inoperable

Other features of the system outside of verification of service delivery (e.g. scheduling, billing, monitoring health and safety of individuals receiving services, etc.)

Identify any challenges you have faced with EVV implementation and ongoing management and provision of the service including challenges specific to service providers and individuals receiving services. For example, unintended consequences or financial costs to the individual receiving services. Describe solutions or efforts to mitigate challenges that were employed.

Describe the systems capability of interfacing with multiple service providers who have existing EVV, with MCOs, timekeeping and payroll systems including a description of how the data is collected and reported in a uniform/streamlined manner to an MCO or State Medicaid Agency.

 The vendor should provide potential benefits of implementing this service in Nevada or any other supporting information that may assist in our justification to fund this type of service. (Return on Investment, positive outcomes for members, cost avoidance). Provide data, if available.

 Financial/Total Cost of Ownership

The State of Nevada is on a biennial legislative/budget timeline. Vendors must consider that this Request for Information (RFI) is different from a Request for Proposal (RFP) where low costs are the target. In this case, if costs are estimated too low, appropriate funding may not be budgeted to acquire the best solution. Costs schedules must include costs of the project as described in this RFI and separately, with any changes recommended by the vendor.

Provide complete operational and implementation cost details for all parties, including individuals served, providers of service, managed care organizations, and the state Medicaid agency. Information should be provided on the costs associated with any tool or technology and the operational costs. Specify if the solution must be purchased versus rented.

Provide, to the extent possible, an estimated cost model to purchase, implement, and operate your described solution including unit costs based on key variables such as data users, source systems, interfaces, and the pricing scales based on those key variables.

Respondents must clearly state all assumptions underlying your pricing responses (e.g., charge basis, charge variances and sensitivities, etc.).

5. RFI TIMELINE

TASK DATE/TIME

Release date May 31, 2017

Deadline for submitting questions June 7, 2017 by 5:00 pm PST

Answers to all questions submitted available on or about June 14, 2017 by 5:00pm PST

RFI response due no later than June 23, 2017 @ 3:00 pm PST

***NOTE: These dates represent a tentative schedule of events. The State reserves the right to modify these dates at any time, with appropriate notice to prospective vendors.

6. PROPRIETARY INFORMATION

Any portion of the submitted response which is asserted to be exempt from disclosure under Nevada Statutes, shall be clearly marked “exempt”, “confidential”, or “trade secret” (as applicable) and shall also contain the statutory basis for such claim on every page. Pages containing trade secrets shall be marked “trade secret as identified in Nevada Statutes”. Failure to segregate and identify such portions shall constitute a waiver of any claimed exemption and the DHCFP will provide such records in response to public records requests without notifying the respondent. Designating material simply as “proprietary” will not necessarily protect it from disclosure under Nevada Statutes. An entire response should not be considered trade secret.

7. QUESTIONS AND ANSWERS

For purposes of addressing questions concerning this RFI, the sole contact will be the Division of Health Care Financing and Policy. The Division of Health Care Financing and Policy will only accept written questions relating to this RFI, which are received via e-mail or fax. The deadline for submitting questions is June 7, 2017 by 5:00 pm, Pacific Time.

Questions must reference the identifying RFI number and be sent via e-mail to the State of Nevada, Division of Health Care Financing and Policy, Attention: EVV RFI . Please provide company name, address, phone number, e-mail address, fax number, and contact person when submitting questions.

All questions will be addressed in writing and responses e-mailed to prospective vendors submitting questions on or about June 14, 2017.

8. RESPONSE REQUIREMENTS & SUBMISSION

Respondents to this RFI shall submit their response as designated below:

One (1) original marked “MASTER”
Two (2) identical copies

Proposal shall be submitted to the State in a sealed package and be clearly marked:

“Technical Proposal in Response to RFI No.XXXX

If the separately sealed proposal, marked as required above, are enclosed in another container for mailing purposes, the outermost container must fully describe the contents of the package and be clearly marked:

REQUEST FOR INFORMATION NO.: XXXX

RFI RESPONSE OPENING DATE: June 23, 2017 @ 3:00 pm

FOR: Personal Care Services (PCS) Electronic Visit Verification System

Proposal should be received at the address referenced below no later than 3:00 pm Pacific Standard Time, on June 23, 2017. Responses that do not arrive by proposal opening time and date may not be considered in the development of this project. Vendors may submit their proposal any time prior to the above stated deadline.

Responses shall be submitted to:

State of Nevada, Division of Health Care Financing and Policy

1100 E. William St., Carson City, Nevada 89701

E-Mail Address:

9. COSTS

The State of Nevada, DHCFP, will not be responsible for any respondent costs associated with preparing a response to this RFI. All costs associated with preparing and responding to this RFI is the sole responsibility of the respondent.

10. RIGHT TO CANCEL

The State of Nevada DHCFP reserves the right to cancel this RFI at any time.

11. ACCEPTANCE OF RESPONSES

All responses properly submitted will be accepted.

All material submitted become the property of the State of Nevada. Materials may be evaluated by anyone designated by the State as part of the response evaluation committee.

12. RESPONSE NOT MANDATORY

Failure to respond to this RFI in whole or in part will not disqualify any “Company” from participation in any subsequent solicitation regarding this matter.

13. RESPONSE NON-BINDING

An RFI is not a procurement process and may not be used to enter into a contract. This RFI will not result in a contract award; a response to a RFI is not an offer and may not be accepted to form a binding contract.

14. REVIEW OF RESPONSES

DHCFP will establish an impartial review committee to review the responses to the RFI, and reserves the right to consult with other state experts and stakeholders.

15. SUBSEQUENT SOLICITATIONS

Information obtained through this RFI may be used to shape future development plans for the PCS Electronic Verification System, including the potential for issuing a request for proposals for the type of services identified in this process.

16. DIVISION OF HEALTH CARE FINANCING & POLICY

Additional information about the Nevada Division of Health Care Financing and Policy can be found on the Agency’s website at: https://dhcfp.nv.gov

Thank you for your interest and response to this Request for Information.