Actuarial Services

Agency: State Government of New Hampshire
State: New Hampshire
Type of Government: State & Local
NAICS Category:
  • 541612 - Human Resources Consulting Services
Posted Date: Sep 14, 2021
Due Date: Oct 21, 2021
Solicitation No: RFP-2022-DMS-01-ACTUA
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Description

This Request for Proposals (RFP) is published to solicit proposals for the provision of actuarial services and technical support for the Department’s Division of Medicaid Services. The Department is procuring the following services:

  • Actuarial services
  • Technical assistance

The selected Vendor and their proposed staff must demonstrate experience setting and certifying Medicaid capitation rates for State Medicaid agency clients in the past three (3) years and experience with Section 1115 Demonstration budget neutrality development and monitoring in the past five years.

Documents RFP-2022-DMS-01-ACTUA

Appendix D: Budget Sheet (09/14/2021)
Appendix E: Staffing Plan (09/14/2021)
Release Date September 14, 2021
Closing Date/Time October 21, 2021. 11:59 PM
Program Area Division of Medicaid Services
Contact Brooke Provost
Telephone (603) 271-9673
E-mail Address Brooke.L.Provost@dhhs.nh.gov

Attachment Preview

State of New Hampshire
Department of Health and Human Services
REQUEST FOR PROPOSALS
RFP-2022-DMS-01-ACTUA
FOR
Actuarial Services
September 14, 2021
New Hampshire Department of Health and Human Services
Actuarial Services
TABLE OF CONTENTS
1. INTRODUCTION
4
Purpose and Overview
4
Contract Period
4
2. BACKGROUND
4
Background
5
3. STATEMENT OF WORK
6
Scope of Services – Actuarial Services
6
Scope of Services – Technical Assistance
9
Readiness Testing
10
Mock Actuarial Presentations
10
Performance Measures
12
Compliance
12
Contract Monitoring Provisions
17
4. FINANCE
17
Budget, Staff List and Budget Narrative
17
5. PROPOSAL EVALUATION
18
Selection
18
Technical Proposal
18
Cost Proposal
18
6. PROPOSAL PROCESS
19
Contact Information – Sole Point of Contact
19
Procurement Timetable
19
Letter of Intent
20
Questions and Answers
20
Exceptions
21
RFP Amendment
22
Proposal Submission
22
Non-Collusion
22
Collaborative Proposals
23
Validity of Proposals
23
Property of Department
23
Proposal Withdrawal
23
Public Disclosure
23
Non-Commitment
24
Liability
24
Request for Additional Information or Materials
24
Oral Presentations and Discussions
24
Successful Proposer Notice and Contract Negotiations
25
Scope of Award and Contract Award Notice
25
Site Visits
25
Protest of Intended Award
25
Contingency
25
RFP-2022-DMS-01-ACTUA
Page 2 of 31
New Hampshire Department of Health and Human Services
Actuarial Services
Ethical Requirements
26
7. PROPOSAL OUTLINE AND REQUIREMENTS
26
Presentation and Identification
26
Outline and Detail
26
8. MANDATORY BUSINESS SPECIFICATIONS
30
Contract Terms, Conditions and Liquidated Damages, Forms
30
9. ADDITIONAL INFORMATION
31
Appendix A – Form P-37 General Provisions and Standard Exhibits
31
Appendix B – Contract Monitoring Provisions
31
Appendix C – CLAS Requirements
31
Appendix D, Budget Sheet
31
Appendix E – Staffing Plan
31
Attachment A – State Fiscal Year (SFY) 2022 Capitation Rate Development for Medicaid Care
Management Program.
31
Attachment B – Waivers
31
RFP-2022-DMS-01-ACTUA
Page 3 of 31
New Hampshire Department of Health and Human Services
Actuarial Services
1. INTRODUCTION
Purpose and Overview
This Request for Proposals (RFP) is published to solicit proposals for the provision of
actuarial services and technical support for the Department’s Division of Medicaid
Services. The Department is procuring the following services:
Actuarial services.
Technical assistance.
The selected Vendor and their proposed staff must demonstrate experience setting
and certifying Medicaid capitation rates for State Medicaid agency clients in the past
three (3) years and experience with Section 1115 Demonstration budget neutrality
development and monitoring in the past five years.
The New Hampshire Department of Health and Human Services (Department)
anticipates awarding one (1) contract for the services in this RFP.
Contract Period
The Contract resulting from this RFP is anticipated to be effective January 1, 2022, or
upon Governor and Executive Council approval, whichever is later through June 30,
2024.
The Department may extend contracted services for up to four (4) additional years,
contingent upon satisfactory Contractor performance, continued funding, and
Governor and Executive Council approval.
2. BACKGROUND
New Hampshire Department of Health and Human Services, Division of
Medicaid Services
NH Medicaid is a federal and state funded health care program that serves a wide
range of needy individuals and families who meet certain eligibility requirements.
The program works to ensure that eligible adults and children have access to
needed health care services by enrolling and paying providers to deliver covered
services to eligible recipients.
The Department commenced the Medicaid Care Management (MCM) program in
December 2013. The MCM program includes acute care medical, behavioral
health and pharmacy services for nearly all Medicaid beneficiaries. At the present
time, approximately 225,000 (178,000 before the Public Health Emergency)
individuals receive their health care through this program, which is currently
administered by three (3) Medicaid managed care organizations (MCOs). The
current managed care contracts are full-risk contracts utilizing capitated rates.
The Department currently has Section 1115 demonstration authority for operation
of a substance use disorder Institutions for Mental Diseases (IMD) exclusion
waiver and is pursuing an amendment to the SMI IMD waiver for mental health
institutions.
RFP-2022-DMS-01-ACTUA
Page 4 of 31
New Hampshire Department of Health and Human Services
Actuarial Services
Background
Actuarial services and technical support must meet New Hampshire and federal
requirements to operate a MCM Program. The services of an actuary are required
to establish and certify capitation rates paid to managed care providers, to perform
risk adjustment and risk settlement of those rates, Section 1115 budget neutrality
development and monitoring, support the Department in its interaction with
Centers for Medicare & Medicaid Services (CMS) on actuarial matters, and to
conduct other requested financial analysis of care management and fee-for-
service Medicaid programs. See Attachment A – State Fiscal Year (SFY) 2022
Capitation Rate Development for Medicaid Care Management Program.
RFP-2022-DMS-01-ACTUA
Page 5 of 31

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