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Amendment of Solicitation AUTHORITY State of Oklahoma OKLAHOMA HEALTH CARE Amendment of Solicitation AUTHORITY Date of Issuance: January 9, 2017 Solicitation No. 8070000933 Requisition No. 8070000933 Amendment No. 3 Hour and date specified for receipt of offers is changed: No Yes, to: CST Pursuant to OAC 580:16-7-30(d), this document shall serve as official notice of amendment to the Solicitation identified above. Such notice is being provided to all suppliers to which the original solicitation was sent. Suppliers submitting bids or quotations shall acknowledge receipt of this solicitation amendment prior to the hour and date specified in the solicitation as follows: (1) Sign and return a copy of this amendment with the solicitation response being submitted; or, (2) If the supplier has already submitted a response, this acknowledgement must be signed and returned prior to the solicitation deadline. All amendment acknowledgements submitted separately shall have the solicitation number and bid opening date printed clearly on the front of the envelope. ISSUED BY and RETURN TO: U.S. Postal Delivery: Sheila Killingsworth Oklahoma Health Care Authority Contracting Officer 4345 North Lincoln Boulevard (405) - 522 - 7846 Oklahoma City, OK 73105 - Phone Number or Personal or Common Carrier Delivery: [email protected] Oklahoma Health Care Authority E-Mail Address 4345 North Lincoln Boulevard Oklahoma City,OK 73105 - Description of Amendment: a. This is to incorporate the following: Amendment Three Round One Questions and Answers with additional questions 301-352 which should have been included with the December 22, 2016 Amendment Two Fiscal Year 2016 Annual Review of Hepatitis C Medications and 30-Day Notice to Prior Authorize Viekira XR™ (Dasabuvir/Ombitasvir/Paritaprevir/Ritonavir) and Epclusa® (Sofosbuvir/Velpatasvir) b. All other terms and conditions remain unchanged. Supplier Company Name (PRINT) Date Authorized Representative Name (PRINT) Title Authorized Representative Signature OMES-FORM-CP-011SA (01/2013) PAGE 1 OF 1 Solicitation No. 8070000933 Questions and Answers Section or Section or Question Solicitation Subsection Subsection Question Response Number Page Number Title Oklahoma Oklahoma statutes can be accessed online at the following address: Example 2.1.1.1 Health Care # Are Oklahoma's statutes available online? http://www.oklegislature.gov/osstatuestitle.html Authority Will OHCA consider releasing the answers to the second round of No. Solicitation questions from bidders earlier, possibly by February 15, 2017, so 1 1.3 15 Timeline that MCO bidders can have enough time to factor in that guidance for their final proposals? Solicitation Since a COA is required at contract date, will the OHCA provide Contract Award still remains in To Be Determined (TBD) status. 2 1.3 15 Timeline a specific estimated award date? How can I view the 1915c Waivers? Information is publicly available at: 48, 50, 66, 3 2 Model Contract http://www.okhca.org/individuals.aspx?id=8137&terms=1915c%20Wai 67, 177 ver Does any information in the RFP relate to medical Numerous locations address authorizations including: Transition of Care 81, 82, 83, authorizations? General Provisions, Transition of Care Period, Member Handbook 97, 138, 147- Content, Provider Services Call Center, Prior Authorization Timelines, 4 2 Model Contract 148, 155, Care Management Supervisor Responsibilities and Qualifications, 159, 191, etc. Electronic Care Management System, etc. Care and Is there a preference or a concern if responders offer a Special Responders should highlight relevant expertise in their submission. 5 2.11 Disease 153 Needs Plan to coordinate the Medicare benefits for members Management seeing providers who do not participate in the CPC+ program? Will there be an opportunity to meet with OHCA in person to No. Care and further discuss key components of Care Coordination as it relates 6 2.11 Disease 153 to the SoonerHealth+ program and contract requirements prior to Management the RFP response deadline? 1 Solicitation No. 8070000933 Questions and Answers There are a variety of programs and initiatives aimed at As noted in section 1.1.1, "SoonerCare Program Background," ABD providing care coordination for the SoonerHealth+ population in members will discontinue receiving services through these initiatives addition to Care Coordination expected to be provided by the when enrolled in the SoonerHealth+ Program. The SoonerCare Choice Contractor, including but not limited to, Health Management program and the OHCA care management initiatives will continue to Care and Program (HMP), Comprehensive Primary Care Plus (CPC+), operate for populations not enrolling in the SoonerHealth+ Program. 7 2.11 Disease 153 Primary Care Case Management (PCCM) and Patient Centered Contractors will be responsible for performing care coordination for Management Medical Home (PCMH). Will these programs carve out Care SoonerHealth+ members. (See section 2.11.10, "CPC+ Care Coordination efforts on behalf of the Contractor and how does Management Procedures" for details on the care management OHCA foresee these programs working together? requirements for Contractors and CPC+ practices.) Will there be a daily and/ or monthly enrollment file? Will the The OHCA will collaborate with the awarded Contractors on enrollment 8 2.5 Enrollment 71 file have TPL and Waiver information? file specifications. Is OHCA's definition of a nursing facility limited to a specific All. Provider 9 2.8 109 type or does it include Outpatient, Inpatient, Rehab Centers, Network CORF/ORF, Nursing Homes, etc. Will a newborn be enrolled under its own Member Medicaid ID? Yes, a newborn will be enrolled under its own Member Medicaid ID. Is the MCO expected to enroll the newborn prior to receiving the Yes, the eNB1 process generates a member ID for the newborn and adds newborn on the 834 enrollment file? to the existing case in near-real-time. If newborns are not added through 10 2.5.2.6 Enrollment 73 eNB1, a manual enrollment and reconciliation are available. The newborn is the plan’s responsibility for all needed services until data are reconciled and the newborn is included on the 834 file. Contractor must provide member handbook within 15 days after Calendar days. Per Appendix 1 - Definitions and Acronyms, "days is receiving notification of member’s enrollment and within seven defined as calendar days unless otherwise specified." 11 2.7.4.1 Enrollment 96 days of member’s request for a new handbook. Is this business or calendar days? 2 Solicitation No. 8070000933 Questions and Answers In the introduction, the word “holistic” is used to describe the Contractors are expected to develop a person-centered care planning systems of supports. That is a wonderful target, but this RFP approach that comprehensively addresses and supports all identified seems to be missing several key, “value-added” components to needs and goals, including meaningful employment, if applicable. SoonerCare ensure a holistic approach. For example, employment is not 12 1.1.1 Program 3 mentioned. When we assure this population has a real shot at Background meaningful employment, we work ourselves out of providing care for this population. Why is employment (as a goal, and in terms of true person-centered planning) not addressed in this bid? There is no significant mention of the role of assistive technology. Contractors are expected to develop a person-centered care planning Again, a true holistic approach includes a significant investigation approach that comprehensively addresses and supports all identified SoonerCare of low-, medium- and high tech assistive devices. This aides needs and goals, including assistive technology, if applicable. 13 1.1.1 Program 3 independent living, employment goals, educational attainment, Background and MANY other value-added, positive outcomes for persons with disabilities. Can Assistive Technology become a more major component of the contractors’ work? SoonerCare Please provide a list of vendors mandated by OHCA for use A list cannot be provided at this time. Program pursuant to the RFP, identifying the administrative or delegated Background/Tra services they provide. nsitioning 14 1.1.1/2.6.3.2 3, 85 Members with an Existing Care or Treatment Plan Can the state provide the total number of dual eligible individuals Available data on dual eligibles can be found in the research section of Population 15 1.1.3 7 in the population? the OHCA website. Additional information will be included in the Counts actuarial data book to be released in January. Population What percentage of the 7,442 ID individuals on the waitlist are 42% are children. 16 1.1.3 7 Counts children vs. adults? Population What percentage of the 154, 795 total members receive 22.50% 17 1.1.3 7 Counts behavioral health services? 3 Solicitation No. 8070000933 Questions and Answers The RFP mentions a waiver waiting list for children and adults. Is Yes. the IDD waiver the only waiver with a waiting list? Population 18 1.1.3 8 The RFP also mentions that 65% of members on the waiting list Personal care HCBS type services are covered under the State Plan Counts are enrolled in SoonerCare and receiving State Plan benefits. Benefit. What HCBS type services are covered under the State Plan Benefit? Population Can the OHCA provide an eligibility map by county of enrollees? The map cannot be provided at this time. Counts, 19 1.1.3, 1.2.4 Geographic 7, 10 Scope of Contracts Please identify any agencies, departments or entities bidder is Noted in 1.2.2, Page 9, there is to be no communication between prohibited from communicating with during the procurement potential Bidders and any employees of the OHCA during this RFP OHCA Sole period. process. Any questions or concerns must be submitted via email to the 20 1.2.2 9 Point of Contact Sole Point-of-Contact, Contract Coordinator identified within the RFP using the appropriate RFP document located on the OHCA’s website. All RFP-related inquiries must be directed as such. Bidders are required to identify what documents or portions of Bidders are requested to include a listing of proposal page numbers with Bids Subject to documents they consider to be confidential and submit redacted redacted material and the basis for the redaction.
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