Administrative Services

MATERIEL

STATE PURCHASING BUREAU

Request for Proposal for Contractual Services

RFP Number 5151Z1

BUYER:

Michelle Thompson/Teresa Fleming

OPENING DATE:

January 5, 2016

PROJECT DESCRIPTION:

The State of Nebraska is seeking a qualified Contractor to provide full-risk, capitated Medicaid managed care program for physical health, behavioral health, and pharmacy services.

Written Questions regarding the project are due no later than November 2, 2015.

Project Documents
Date Posted
Document Format(s)

Pre-Solicitation Notice and Schedule of Events for Medicaid Integrated Managed Care Procurement

10/19/15

PDF

Word

Request for Proposal

10/21/15

PDF

Word

Attachment 1 - Medicaid Enrollees by County, State FY 2015

10/21/15

PDF

Attachment 2 - Access Standards

10/21/15

PDF

Attachment 3 - Nebraska Counties Classified by Urban, Rural, Frontier Status

10/21/15

PDF

Attachment 4 - Patient-Centered Medical Home Standards

10/21/15

PDF

Attachment 5 - Policies, Procedures, and Plans

10/21/15

PDF

Attachment 6 - Reporting Requirements

10/21/15

PDF

Attachment 7 - Performance Measures

10/21/15

PDF

Attachment 8 - PBM Claims Processing Edits for the Nebraska Medicaid Psychotropic Drugs and Youth Initiative

10/21/15

PDF

Attachment 9 - Rating Regions

10/21/15

PDF

Attachment 10 - A - Physical and Behavioral Health Databook, Rating Region 1

10/21/15

PDF

Attachment 10 - B - Physical and Behavioral Health Databook, Rating Region 2

10/21/15

PDF

Attachment 10 - C - Dual Databook (1)

10/21/15

PDF

Attachment 10 - D - Long Term Services and Supports Databook

10/21/15

PDF

Attachment 11 - Rates

10/21/15

PDF

Attachment 12 - Historical Transplant Cost Distribution Data

10/21/15

PDF

Attachment 13 - Neb. Rev. Stat. §71-831

10/21/15

PDF

Attachment 14 - Quality Performance Program Measures - Contract Year One

10/21/15

PDF

Attachment 15 - Medical Loss Ratio Requirements

10/21/15

PDF

Attachment 16 - Critical Access Hospitals

10/21/15

PDF

Attachment 17 - 2015 Health Care Acquired Conditions

10/21/15

PDF

Attachment 18 - Liquidated Damages

10/21/15

PDF

Attachment 19 - Proposal Statements and Questions

10/21/15

PDF

Evaluation Criteria

10/21/15

PDF

Pre-proposal Conference Agenda

10/23/15

PDF

Addendum 1 - Questions and Answers

10/23/15

PDF

Word

First Pre-Proposal Registration Sheets

10/26/15

PDF

Heritage Health Pre-Proposal Conference

10/26/15

Power Point

NE Heritage Health Bidder's Conference Rate Presentation (Optumas)

10/26/15

PDF

Addendum 2 - Revised Schedule of Events

11/09/15

PDF

Word

Addendum 3 - Revisions to RFP

11/10/15

PDF

Word

Addendum 4 - Revised Schedule of Events

11/17/15

PDF

Word

Addendum 5 - Revised Schedule of Events

11/18/15

PDF

Word

Addendum 6 - Questions and Answers 1 - 220

11/18/15

PDF

Addendum 7 - Questions and Answers 221 - 382

11/19/15

PDF

Attachment 20 - COA-level Rate Development

11/18/15

PDF

Attachment 21 - Non-Medical Load Assumption

11/18/15

PDF

Attachment 22 - Heritage Health Rate Development Narrative

11/18/15

PDF

Attachment 23 - COS and COA Trends

11/18/15

PDF

Attachment 24 - NEMT-Ambulance Rates

11/18/15

PDF

Attachment 25 - IBNR Assumptions by Sources

11/18/15

PDF

Attachment 26 - MLR and Risk Corridor Examples

11/18/15

PDF

Attachment 27 - FQHC-2015-rates

11/18/15

PDF

Attachment 28 - Rural Health Clinic Rates Effective 07-01-2015

11/18/15

PDF

Attachment 29 - Unit Definitions for Category of Service

11/18/15

PDF

Attachment 30 - Supplemental Enrollment File

11/18/15

PDF

Attachment 31 - Unborn File

11/18/15

PDF

2nd Pre-Proposal Conference Agenda

11/19/15

PDF

Word

Addendum 8 - Revised Schedule of Events

11/20/15

PDF

Second Pre-Proposal Conference Registration Sheet

11/23/15

PDF

Heritage Health Second Pre-Proposal Conference

11/23/15

Power Point

NE - Heritage Health Second Bidder's Conference Presentation - Optumas

11/23/15

PDF

Addendum 9 - Questions and Answers, 2nd Round

12/17/15

PDF

Addendum 10 - Additional Revisions to RFP

12/17/15

PDF

Attachment 32 - Nebraska Medicaid Eligible Providers

12/17/15

Excel

Attachment 33 - Heritage Health - FFS by County

12/17/15

PDF

Attachment 34 - Rate Adjustment Crosswalk

12/17/15

PDF

Attachment 35 - Rate Adjustment Detail

12/17/15

PDF

Attachment 36 - COA Crosswalk

12/17/15

PDF

Attachment 37 - Delivery Costs by COA

12/17/15

PDF

Attachment 38 - Revised Reporting Requirements

12/17/15

PDF

Attachment 39 - Revised Access Standards

12/17/15

PDF

Addendum 11 - Additional Revisions to RFP

12/22/15

PDF

Attachment 40 - Updated MLR and Risk Corridor Examples

12/22/15

PDF

Addendum 12

12/30/15

PDF

List of Respondents Released

01/05/16

PDF

Word

Evaluation Period

01/12/16 - 01/29/16

 

Oral Presentations/ Demonstrations (if applicable)

Not Applicable

 

Best and Final Offer (if applicable)

Not Applicable

 

Intent to Award Recommendation Received from Agency

01/31/16

 

Evaluation Scoring Verification

02/05/16

 

Intent to Award Posted

02/05/16

PDF

Final Evaluation Document

02/05/16

PDF

WellCare of Nebraska, Inc Protest of Intent to Award

03/02/16

PDF

AmeriHealth, Inc. (d/b/a Arbor Health Plan) Protest of Intent to Award

03/02/16

PDF

State's Response to Wellcare of Nebraska, Inc Protest

03/02/16

PDF

State's Response to AmeriHealth, Inc. (d/b/a Arbor Health Plan) Protest

03/02/16

PDF

Notice of Withdrawal of Intent to Award

03/02/16

PDF

Final Re-Evaluation Document

03/08/16

PDF

Intent to Award

03/08/16

PDF

Re-Evaluation Score Sheets - Corporate Overview

03/08/16

PDF

Coventry Health Care of Nebraska, Inc. d/b/a Aetna Better Health of Nebraska Protest of Intent to Award

04/08/16

PDF

AmeriHealth, Inc. (d/b/a Arbor Health Plan) Protest of Intent to Award

04/08/16

PDF

State's Response to Coventry Health Care of Nebraska, Inc. d/b/a Aetna Better Health of Nebraska

04/08/16

PDF

State's Response to AmeriHealth, Inc. (d/b/a Arbor Health Plan)

04/08/16

PDF

Secretary of State Registration/Letter of Good Standing

XX/XX/XX

 

Certificate of Insurance Received from Intended Contractor

XX/XX/XX

 

Submission of Performance Bond (if applicable)

XX/XX/XX

 

Finalization of Terms and Conditions

XX/XX/XX

 

Paperwork Processed for Contract Generation

XX/XX/XX

 

Contract Award Issuance

XX/XX/XX

 

Contract Signing and Distribution

XX/XX/XX

 

Contracts 71163(O4), 71164(O4), and 71165(O4) Effective January 1, 2017 through December 31, 2022

04/14/16

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