Rate Build Up Rate Setting

Agency: State Government of New Hampshire
State: New Hampshire
Type of Government: State & Local
Posted Date: Oct 21, 2021
Due Date: Nov 4, 2021
Solicitation No: RFP-2022-DLTSS-06-RATEB
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Description

This Request for Proposals (RFP) is published to solicit proposals for the provision of rate build up rate setting services for the Bureau of Developmental Services (BDS) as applicable to the §1915(c) HCBS Waivers, including waivers for Acquired Brain Disorder services, Home Supports for Children with Developmental Disabilities, and People with Developmental Disabilities.

Documents

RFP-2022-DLTSS-06-RATEB
Addendum #1 (10/01/2021)
Addendum #2 (10/18/2021)

Program Staff List (09/28/2021)
Budget Worksheet (09/28/2021)

Release Date September 28, 2021
Closing Date/Time November 4, 2021, 11:59 PM
Program Area Division of Long Term Supports and Services (DLTSS)
Contact Nikki Gauthier
Telephone (603) 271-9493
E-mail Address contracts@dhhs.nh.gov

Attachment Preview

State of New Hampshire
Department of Health and Human Services
REQUEST FOR PROPOSALS
RFP-2022-DLTSS-06-RATEB
FOR
Rate Build Up Rate Setting
September 28, 2021
New Hampshire Department of Health and Human Services
Rate Build Up Rate Setting
TABLE OF CONTENTS
1. INTRODUCTION
4
Purpose and Overview
4
Contract Period
4
2. BACKGROUND
4
New Hampshire Department of Health and Human Services, Bureau of Developmental Services
4
Background
4
3. STATEMENT OF WORK
5
Scope of Services
5
Reporting Requirements
9
Performance Measures
9
Compliance
9
Contract Monitoring Provisions
14
4. FINANCE
14
Financial Standards
14
5. PROPOSAL EVALUATION
14
Selection
14
Technical Proposal Standards
14
Technical Proposal
16
Budget, Staff List and Budget Narrative
16
Cost Proposal
18
6. PROPOSAL PROCESS
18
Contact Information Sole Point of Contact
18
Procurement Timetable
19
Letter of Intent
19
Questions and Answers
19
Exceptions
21
RFP Amendment
21
Proposal Submission
21
Non-Collusion
22
Collaborative Proposals
22
Validity of Proposals
22
Property of Department
22
Proposal Withdrawal
22
Public Disclosure
22
Non-Commitment
23
Liability
23
Request for Additional Information or Materials
24
Oral Presentations and Discussions
24
Successful Proposer Notice and Contract Negotiations
24
Scope of Award and Contract Award Notice
24
Site Visits
24
Protest of Intended Award
25
Contingency
25
Ethical Requirements
25
7. PROPOSAL OUTLINE AND REQUIREMENTS
25
Presentation and Identification
25
Outline and Detail
26
RFP-2022-DLTSS-06-RATEB
Page 2 of 30
New Hampshire Department of Health and Human Services
Rate Build Up Rate Setting
8. MANDATORY BUSINESS SPECIFICATIONS
29
Contract Terms, Conditions and Liquidated Damages, Forms
29
9. ADDITIONAL INFORMATION
30
Appendix A Form P-37 General Provisions and Standard Exhibits
30
Appendix B Contract Monitoring Provisions
30
Appendix C CLAS Requirements
30
Appendix D Budget Sheet
30
Appendix E Program Staff List
30
RFP-2022-DLTSS-06-RATEB
Page 3 of 30
New Hampshire Department of Health and Human Services
Rate Build Up Rate Setting
1. INTRODUCTION
Purpose and Overview
This Request for Proposals (RFP) is published to solicit proposals for the provision of
rate build up rate setting services for the Bureau of Developmental Services (BDS) as
applicable to the §1915(c) HCBS Waivers, including waivers for Acquired Brain
Disorder services, Home Supports for Children with Developmental Disabilities, and
People with Developmental Disabilities.
Qualified vendors must have experience in developing rate methodology for home and
community based services, specific to developmental disability services, in a minimum
of two (2) other states. Qualified vendors must demonstrate depth of knowledge
regarding:
Developmental disabilities services and processes.
Needs of the populations receiving services, including understanding
geographical barriers to services.
Centers for Medicare and Medicaid Services (CMS), Medicaid enrollment,
and Medicaid billing.
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 December 1, 2021,
or upon Governor and Executive Council approval, whichever is later through
November 30, 2023.
The Department may extend contracted services for up to two (2) 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, Bureau of
Developmental Services
The Bureau of Developmental Services (BDS) joins communities and families in
providing opportunities for citizens with developmental disabilities or acquired brain
disorders to achieve health and independence. In partnership with individuals,
families, and community based service networks, BDS affirms the vision that all
citizens should participate in the life of their community while receiving the supports
they need to be productive and valued community members.
Background
The Department last updated the rate methodology for the BDS waivers in 2007.
However, the current rate methodology limits the ability to identify changes that could
result in modification of reimbursement rates in a manner that incentivizes services in
a fair and equitable manner.
RFP-2022-DLTSS-06-RATEB
Page 4 of 30
New Hampshire Department of Health and Human Services
Rate Build Up Rate Setting
The Center for Medicare and Medicaid Services (CMS) has approved the
Department’s request to extend dates to meet the Compliance with Conflict of Interest
& Direct Billing Requirements of the §1915(c) HCBS Waivers. For more detailed
information regarding the reasons for the extension request and associated Corrective
Action Plan, please visit: https://www.dhhs.nh.gov/dcbcs/bds/coi-cap.htm .
Waivers are an essential and critical component for the delivery of services to
individuals with disabilities and their families and compliance is critical for the
continuation of the Center of Medicare and Medicaid (CMS) federal funding.
Currently, there are ten (10) designated area agencies enrolled as Medicaid providers
for BDS Medicaid Waiver services. The ten (10) designated area agencies
independently contract with a network of approximately seventy (70) private vendors
to increase service access and system capacity.
Ensuring that provider rates adequately sustain needed capacity is critical to
transitioning to direct Medicaid billing.
In addition, the Department will be considering the current structure of its
Developmental Disability waivers and seeking opportunities and benefits of creating
two segments or tiers, including a comprehensive waiver and a supports waiver. The
rate setting methodology must take into consideration a tiered waiver structure.
This RFP identifies rate analysis activities already conducted by the Department.
Additionally, a strategic assessment of Department operations has been conducted
and includes suggestions for rate methodology changes with the Developmental
Disabilities Medicaid Waiver services. Results of the assessment can be found online
at https://www.dhhs.nh.gov/ocom/presentations.htm and specific suggestions for rate
build up rate setting for the BDS begin on Page 35 of the document.
3. STATEMENT OF WORK
Scope of Services
3.1.1.
The selected Vendor(s) must review the Department’s current rate
methodology and work completed to date in relation to analyzing
reimbursement rates for services provided to individuals who engage
services for individuals with developmental disabilities or acquired brain
disorders. The Department, to date, has completed activities that
include:
3.1.1.1. Engaging the Department’s Rate Setting Unit to review six (6)
years of historical claims data in order to identify trends that
can inform current rates.
3.1.1.2. Leading extensive stakeholder engagement activities with the
Organized Health Care Delivery System for Developmental
Disabilities services, which includes the ten (10) Area
Agencies; private providers, and independent case
management agencies, as well as other key stakeholders, that
include but are not limited to:
3.1.1.2.1. NH Family Voices.
RFP-2022-DLTSS-06-RATEB
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