FY24 Random Moment Sampling State Agencies RFP 25-630-8000-0001

THE NEW MEXICO HUMAN SERVICES DEPARTMENT REQUEST FOR PROPOSALS (RFP) Random Moment Sampling, Medicaid and Title IV-E Administrative Claiming RFP# 25-630-8000-0001 Release: Date: February 14, 2024 Proposal Due Date: March 14, 2024 ii I. INTRODUCTION .................................................................................................................................................. 1 A. PURPOSE OF THIS REQUEST FOR PROPOSALS ............................................................................................. 1 B. BACKGROUND INFORMATION ................................................................................................................... 1 C. SCOPE OF PROCUREMENT ......................................................................................................................... 6 D. PROCUREMENT MANAGER ....................................................................................................................... 6 E. DEFINITION OF

TERMINOLOGY .................................................................................................................. 7 F. PROCUREMENT LIBRARY ......................................................................................................................... 11 II. CONDITIONS GOVERNING THE PROCUREMENT ............................................................................................... 12 A. SEQUENCE OF EVENTS ............................................................................................................................ 12 B. EXPLANATION OF EVENTS ....................................................................................................................... 13 1. Issuance of RFP .................................................................................................................................. 13 2. Acknowledgement of Receipt ............................................................................................................. 13 3. Pre-Proposal Conference .................................................................................................................... 14 4. Deadline to Submit Written Questions ................................................................................................ 14 5. Response to Written Questions ........................................................................................................... 14 6. Submission of Proposal ....................................................................................................................... 15 7. Proposal Evaluation............................................................................................................................ 15 8. Selection of Finalists ........................................................................................................................... 15 9. Best and Final Offers .......................................................................................................................... 15 10. Oral Presentations .............................................................................................................................. 16 11. Finalize Contractual Agreements ........................................................................................................ 16 12. Contract Awards ................................................................................................................................ 16 13. Protest Deadline ................................................................................................................................. 16 C. GENERAL REQUIREMENTS ....................................................................................................................... 17 1. Acceptance of Conditions Governing the Procurement ........................................................................ 17 2. Incurring Cost ..................................................................................................................................... 17 3. Prime Contractor Responsibility .......................................................................................................... 17 4. Subcontractors/Consent ..................................................................................................................... 17 5. Amended Proposals ............................................................................................................................ 17 6. Offeror’s Rights to Withdraw Proposal ................................................................................................ 18 7. Proposal Offer Firm ............................................................................................................................ 18 8. Disclosure of Proposal Contents .......................................................................................................... 18 9. No Obligation ..................................................................................................................................... 19 10. Termination ....................................................................................................................................... 19 11. Sufficient Appropriation...................................................................................................................... 19 12. Legal Review ...................................................................................................................................... 19 13. Governing Law ................................................................................................................................... 19 14. Basis for Proposal ............................................................................................................................... 19 15. Contract Terms and Conditions ........................................................................................................... 19 III. RESPONSE FORMAT AND ORGANIZATION ...................................................................................................... 27 A. NUMBER OF RESPONSES ......................................................................................................................... 27 B. NUMBER OF COPIES ................................................................................................................................ 27 C. PROPOSAL FORMAT ................................................................................................................................ 28 1. Proposal Content and Organization .................................................................................................... 28 2. Letter of Transmittal........................................................................................................................... 29 3. Table of Contents ............................................................................................................................... 29 4. Proposal Summary ............................................................................................................................. 29 5. Response to Department’s Terms and Conditions ................................................................................ 29 iii 6. Offeror’s Additional Terms and Conditions .......................................................................................... 30 7. Response to Mandatory Specifications ................................................................................................ 30 8. Campaign Contribution Disclosure Form ............................................................................................. 30 9. Suspension and Debarment Requirement Form ................................................................................... 30 10. Lobbying ............................................................................................................................................ 30 IV. SPECIFICATIONS .............................................................................................................................................. 31 A. SUMMARY SCOPE OF WORK .................................................................................................................... 31 B. TECHNICAL SPECIFICATIONS .................................................................................................................... 32 1. Organizational Experience .................................................................................................................. 32 2. Organizational References .................................................................................................................. 33 3. Oral Presentation/Product Demonstration .......................................................................................... 34 C. BUSINESS SPECIFICATIONS ...................................................................................................................... 41 1. Financial Stability ............................................................................................................................... 41 2. RESERVED .......................................................................................................................................... 41 3. Letter of Transmittal Form .................................................................................................................. 41 4. Campaign Contribution Disclosure Form ............................................................................................. 41 5. Cost ................................................................................................................................................... 41 6. Resident Business or Resident Veterans Preference ............................................................................. 42 V. EVALUATION ................................................................................................................................................... 43 A. EVALUATION POINT SUMMARY ............................................................................................................... 43 B. EVALUATION FACTORS ............................................................................................................................ 44 C. EVALUATION PROCESS ............................................................................................................................ 46 APPENDIX A – ACKNOWLEDGEMENT OF RECEIPT FORM...................................................................................... 47 APPENDIX B – CAMPAIGN CONTRIBUTION DISCLOSURE FORM ........................................................................... 49 APPENDIX C – SAMPLE CONTRACT ....................................................................................................................... 52 APPENDIX D – COST RESPONSE FORM ................................................................................................................. 74 APPENDIX E – LETTER OF TRANSMITTAL FORM ................................................................................................... 76 APPENDIX F – ORGANIZATIONAL REFERENCE QUESTIONNAIRE ........................................................................... 78 APPENDIX G – SUSPENSION AND DEBARMENT REQUIREMENT ........................................................................... 82 1 I. INTRODUCTION A. PURPOSE OF THIS REQUEST FOR PROPOSALS The purpose of the Request for Proposal (RFP) is to solicit sealed proposals to establish a contract through competitive negotiations for the procurement of Random Moment Sampling (RMS) for Medicaid and Title IV-E Administrative Claiming. Specifically, the New Mexico Human Services Department (HSD) is seeking an organization to provide these services for HSD and New Mexico State Agencies claiming federal financial participation for Medicaid related activities. Agencies include but are not limited to: Aging & Long-Term Services Department (ALTSD), Children, Youth & Families Department (CYFD), Department of Health (DOH), Early Childhood Education and Care Department (ECECD) and University of New Mexico (UNM). Additionally, federal financial participation for Title IV-E Foster Care activities will be calculated for CYFD. The purpose of this Request for Proposal (RFP) is to select a qualified offeror that has the experience and expertise to perform the mandatory requirements of the RMS and administrative claiming to support the Medicaid and Title IV-E programs. B. BACKGROUND INFORMATION This section provides background on HSD, the Medical Assistance Division (MAD) and CYFD programs that may be helpful to the offeror in preparing a proposal. The information is provided as an overview and is not intended to be a complete and exhaustive description. HSD Resources and Locations HSD has more than 1,800 authorized employees and contracts with community-based providers throughout the state. There are thirty-five (35) HSD, Income Support Division (ISD) field office locations statewide, with an additional three (3) satellite offices https://www.hsd.state.nm.us/lookingforassistance/field_offices_1/ There are also eight (8) quality control offices statewide. HSD’s central offices are located in three (3) Santa Fe buildings: Plaza La Prensa (Behavioral Health Services Division and Medical Assistance Division), Rodeo Road Building (Office of the Secretary, Administrative Services Division, Income Support Division, Child Support Division, Office of General Counsel and Office of Inspector General) and Siler Road (Information Technology Division). Organization of HSD The State of New Mexico Human Services Department is a cabinet-level Department in the Executive Branch of New Mexico State government. The Agency is headed by a Cabinet Secretary appointed by the Governor and confirmed by the New Mexico State Senate. Effective July 1, 2024, HSD will become the New Mexico Health Care Authority (HCA) as created by 2023 Senate Bill 16 (SB16), as enacted by the Legislature of the State of New Mexico through amended Section 9-8-2 NMSA 1978 (being Laws 1977, Chapter 252, Section 2), and as signed into law by Governor Michelle Lujan Grisham. The purpose of the Health Care Authority Department Act is to establish a single, unified department to https://www.hsd.state.nm.us/lookingforassistance/field_offices_1/ 2 administer laws and exercise functions relating to health care purchasing, policy, and regulation for the State of New Mexico. The HCA will be a new executive department that has formally and successfully merged HSD, the Employee Benefits Bureau from the General Services Division (GSD), the Developmental Disabilities Supports Division (DDSD) and Division of Health Improvement (DHI) from DOH. HCA will consist of the Office of the Secretary and nine divisions. Only those divisions or bureaus within each division that are related to this RFP are described herein. Office of the Secretary (OOS). The Office of the Secretary consists of the Secretary of Health Care Authority, the three (3) Deputy Cabinet Secretaries, the Office of General Counsel, the Office of Human Resources, Administrative Services Division and the Office of Inspector General. The Secretary provides cabinet-level direction for HCA. The Office of General Counsel provides legal support for the Agency. The Office of Inspector General investigates and pursues cases of fraud and abuse and conducts financial and program audits. The Office of Human Resources serves personnel needs of department employees, handles job recruitments, hiring, reorganizations and career counseling, as well as employee insurance and benefits, handles matters related to department personnel policies, provides coaching to the Agency’s supervisors and managers, works with labor relations and delivers and coordinates training programs and staff development. Administrative Services Division (ASD). The Administrative Services Division provides general administrative support for HCA and all of its programs, including Medicaid. Income Support Division (ISD). The Income Support Division is the primary source for eligibility determination for all HCA programs, including Medicaid. The Division’s field staff of close to 1,000 employees, supervisors and county directors is administered through four district operations offices under the direction of two Deputy Directors. Field staff are responsible for interviewing applicants/recipients, determining eligibility, and issuing benefits for the food stamp, cash assistance, Medicaid and other assistance programs. Medical Assistance Division (MAD). The Medical Assistance Division manages and administers the federal Medicaid program and authorized waivers including the Centennial/Turquoise Care program. Medicaid is authorized under Title XIX of the Social Security Act. Federal contribution levels differ by program and vary based on relative ranking of the state in per capita income. Program Overview Background and History Covered Services. Medicaid program regulations allow reimbursement for a broad array of health services and providers. Mandated services include, but are not limited to: general acute inpatient hospital care; outpatient hospital services; physician services provided in a variety of settings; nurse midwives; nursing facility services for certain individuals; home health care; rural health clinic services including services in Federally Qualified Health Centers; laboratory and radiology; nurse practitioner services; and medically necessary Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) services. Optional 3 services provided in New Mexico include but are not limited to prescription drugs; eyeglasses and hearing aids; organ transplants; dental services; physical, occupational and speech therapies; rehabilitative services; Intermediate Care Facilities for Individual with Intellectual Disabilities (ICF/IID); case management; hospice; transportation services; durable medical equipment and supplies and prosthetic devices. Administration of the Medicaid Program. HCA works collaboratively with other state agencies in managing Medicaid. Specifically, it works with the Department of Health (DOH), Public Education Department (PED), Aging & Long-Term Services Department, Children (ALTSD), Children, Youth & Families Department (CYFD), Early Childhood Education and Care Department (ECECD), New Mexico Corrections Department (NMCD), and Indian Affairs Department (IAD). A program to monitor utilization and detect fraud and abuse is operated by HCA’s Office of Inspector General and the Medicaid Fraud Control Unit of the New Mexico Office of the Attorney General. Fee-For-Service Populations. Some populations for Medicaid benefits are exempt from receiving services through a managed care organization. In those instances, HCA reimburses the providers directly. Provider reimbursement methodology can be found on HCA’s website under Fee Schedules https://www.hsd.state.nm.us/providers/fee-schedules/. This fee schedule is subject to change. Medicaid Administrative Claiming. HCA has authority to delegate administrative functions set for in Title XIX of the Social Security Act in order to employ methods of administration necessary for the proper and efficient operations of the State Plan. HCA has chosen to exercise this right by delegating certain functions to New Mexico State Agencies including but not limited to: Department of Health (DOH), Aging & Long-Term Services Department (ALTSD), Children, Youth & Families Department (CYFD), Early Childhood Education and Care Department (ECECD), University of New Mexico (UNM), and Developmental Disabilities Council (DDC). Medicaid Home and Community-Based Services. Medicaid Home and Community- Based waiver programs are authorized in section 1915 (c) of the Social Security Act. The program permits a state to furnish an array of home and community-based services that assist Medicaid beneficiaries to live in the community and avoid institutionalization. HCA administers three (3) 1915 (c) waiver programs which are operated by the Developmental Disabilities Supports Division. Medicaid Managed Care. Title XIX (Medicaid) of the Social Security Act describes the terms under which a state may implement Medicaid managed care. A state must request a waiver of certain SSA provisions before implementation is possible. Waivers must be approved by CMS. HCA operates an 1115 waiver called Centennial/Turquoise Care. CYFD Resources and Locations CYFD has more than 2,200 authorized employees. There are thirty (30) Protective Services field offices statewide and a 24-hour, seven day a week hotline to report child abuse and neglect, 1-855-333 SAFE (7233) or #SAFE from a cell phone. Juvenile Justice Services https://www.hsd.state.nm.us/providers/fee-schedules/ 4 operates three (3) reintegration centers, four (4) secure facilities, and twenty-six (26) Juvenile Probation Offices statewide. CYFD has two (2) central office locations, one (1) in Santa Fe (old PERA building) and one (1) Albuquerque (Pinetree Location). Contact information can be found at https://www.cyfd.nm.gov/contact-us/. Organization of CYFD The State of New Mexico Children, Youth and Families Department is a cabinet-level Department in the Executive Branch of New Mexico State government. The Agency is headed by a Cabinet Secretary appointed by the Governor and confirmed by the New Mexico State Senate. CYFD is the designated Title IV-E Agency in New Mexico and is charged with ensuring the safety, permanency, and wellbeing of children, youth and their families. CYFD provides foster care, adoption, and kinship guardianship services and support to children and families involved in New Mexico’s child welfare system. CYFD operates the juvenile corrections’ system; and CYFD seeks to prevent abuse, reduce juvenile crime, rehabilitate juvenile offenders, and support healthy families. CYFD is the behavioral health authority for all children in New Mexico. CYFD consists of the Office of the Secretary and five divisions. Only those divisions or bureaus within each division that are related to this RFP are described herein. Office of the Secretary (OTS). The Office of the Secretary consists of the Secretary of Children Youth and Families, three (3) Deputy Cabinet Secretaries, the Office of General Counsel, the Office of Inspector General, the Office of Tribal Affairs, and the Office of Performance and Accountability. The Secretary provides cabinet-level direction for CYFD. The Office of General Counsel provides legal support for the Agency. The Office of Inspector General investigates and pursues cases of fraud and abuse and conducts financial and program audits. The Office of Tribal Affairs acts a liaison between CYFD and New Mexico’s 19 Pueblos, 3 Tribes, and 1 Nation. The Office of Performance and Accountability oversees data and research, compliance with federal regulations and requirements, Title IV-E eligibility program, Medicaid eligibility for children in custody, training, and the agency child welfare database know as FACTS. Program Support Division. The Program Support Division provides general administrative, financial, human resources and Information Technology support for CYFD and all of its programs, including Title IV-E. Protective Services Division. The Protective Services (PS) program area is responsible for the protection and well-being of children. PS provides child protective and foster care, adoption and kinship guardianship services and support to children and families across the State. Services are provided by 30 county offices across the state with more than eight hundred (800) employees. PS is responsible for administering the State’s child abuse and neglect reporting hotline, and public foster care system, providing voluntary in-home services to at risk children and their families to prevent children coming into foster care, https://www.cyfd.nm.gov/contact-us/ 5 licensing private child placement agencies, providing adoption and guardianship services, providing services to youth aging out of foster care, monitoring all public and private adoptions, administering interstate compact programs and reporting on an array of Federal grants related to child welfare. The PS field offices respond to all allegations of child maltreatment and work to protect children from abuse and neglect. Services in the field offices include: • Intake of report if allegations of child abuse and neglect • Child Protective Services (CPS) Investigations • Foster Care Services to children in custody • Voluntary In-home Services • Adoption and Kinship Guardianship Services • Youth Services • Prevention and Family Services • CPS Legal Services PS maintains a 24-hour State Centralized Intake Unit, which is the first line for reporting and referral of possible cases of abuse and neglect. PS also develops policies and procedures for protective services workers as guidelines for protecting children. PS provides and tracks foster care and adoption services for children needing placement and supports those youth that are transitioning from foster care to adulthood and independent living. PS is responsible for administering the Federal and state funds used to provide services to and/or support maltreated children. Summary of Programs Currently Participating in RMS Below is a summary of programs that are currently participating in the RMS and Medicaid Administrative Claiming (MAC). Additional agencies/programs could be added if the HCA chooses to delegate additional Medicaid administrative duties outside of the agency, Department Number of Cost Pools Number of MAC Invoices Required Approx. # of RMS Participants (Based on Jan. – March 2024) Aging & Long-Term Services (ALTSD) 1 1 115 Children, Youth & Families (CYFD) 2 3 – Separate MAC invoices required for each division (BH, JJ & PS) 675 Department of Health (DOH) – Outreach & Maternal Child Health MCH) 2 2 – Separate MAC invoices required for each program (Outreach & MCH) 185 6 Department of Health (DOH) – School- Based Health Centers (SBHC) 2 1 15 Early Childhood Education & Care (ECECD) 2 1 25 University of NM (UNM) Center for Development & Disability (CDD) 2 1 80 C. SCOPE OF PROCUREMENT The scope of the procurement shall encompass the requirements in the contract (Appendix C of this RFP). This procurement will result in a single source award for HCA. The effective date of the proposed contract is July 1, 2024, or upon signature of the New Mexico Contracts Review Bureau (CRB). The initial term of the contract is expected to be four (4) years. In no case shall the contract exceed a total of four (4) years in duration. D. PROCUREMENT MANAGER 1. HCA has assigned a Procurement Manager who is responsible for the conduct of this procurement whose name, address, telephone number and e-mail address are listed below: Name: Victoria Herrera, Procurement Manager Address: Medical Assistance Division New Mexico Health Care Authority PO Box 2348 Santa Fe, NM 87504 Phone: 505-709-5427 Fax: 505-827-3138 E-mail: victoria.herrera@hsd.nm.gov 2. Any inquiries or requests regarding this procurement should be submitted, in writing, to the Procurement Manager. Offerors may contact ONLY the Procurement Manager regarding this procurement. Other state employees or Evaluation Committee members do not have the authority to respond on behalf of the HCA. Protests of the solicitation or award must be delivered by mail to the Protest Manager. As A Protest Manager has been named in this Request for Proposals, pursuant to NMSA 1978, § 13-1-172, ONLY protests delivered directly to the Protest Manager in writing and in a timely mailto:victoria.herrera@hsd.nm.gov 7 fashion will be considered to have been submitted properly and in accordance with statute, rule and this Request for Proposals. Emailed protests will not be considered as properly submitted nor will protests delivered to the Procurement Manager be considered properly submitted. E. DEFINITION OF TERMINOLOGY This section contains definitions of terms used throughout this procurement document, including appropriate abbreviations: “ALTSD” mean the New Mexico Aging and Long-Term Services Department. “Appeal” means a request for a review related to a dispute relating to the eligibility process, service hours, services, supports, etc. “ASD” means the Administrative Services Division of the New Mexico Health Care Authority. “Authorized Purchaser” means an individual authorized by a Participating Entity to place orders against this contract. “Award” means the final execution of the contract document. “Business Hours” means 8:00 AM through 5:00 PM Mountain Standard or Mountain Daylight Time, whichever is in effect on the date given. “Centennial Care” means the existing New Mexico Medicaid Managed Care program in effect through June 30, 2024. Effective July 1, 2024, this program will be renamed Turquoise Care. Managed Care services include physical health, behavioral health, long- term care and community benefits which are provided by the managed care organizations (MCOs). “Close of Business” means 5:00 PM Mountain Standard or Daylight Time, whichever is in use at that time. “CMS” means the Centers for Medicare and Medicaid Services (CMS) which is part of the Federal Health and Human Services Department. “Confidential” means confidential financial information concerning the offeror’s organization and data that qualifies as a trade secret in accordance with the Uniform Trade Secrets Act NMSA 1978 57-3-A-1 to 57-3A-7. See NMAC 1.4.1.45. As one example, no information that could be obtained from a source outside this request for proposals can be considered confidential information. “Contract" means any agreement for the procurement of items of tangible personal property, services or construction. 8 “Contract Manager” means the individual selected by the Agency to monitor and manage all aspects of the contract resulting from this RFP. “Contractor" means any business having a contract with a state agency or local public body. “CRB” means Contracts Review Bureau. “CYFD” means the New Mexico Children, Youth and Families Department. “Day” means business day unless otherwise specified. “DDC” means the New Mexico Developmental Disabilities Council. “Deliverable” means any measurable, tangible, verifiable outcome, result, or item that must be produced to complete a project or part of a project. “Department of Information Technology (DoIT)” means the New Mexico Department of Information Technology which is responsible for operating the data center and all communications related items. “Desirable” The terms “may,” “can,” “should,” “preferably,” or “prefers” identify a desirable or discretionary item or factor (as opposed to “mandatory”). “Determination" means the written documentation of a decision of a procurement officer including findings of fact required to support a decision. A determination becomes part of the procurement file to which it pertains. “DOH” means the New Mexico Department of Health. “ECECD” means the New Mexico Early Childhood Education and Care Department. “Electronic Version/Copy” means a digital form consisting of text, images or both readable on computers or other electronic devices that includes all content that the Original and Hard Copy proposals contain. The digital form may be submitted using a USB flash drive. The electronic version/copy can NOT be emailed. “Employer” means any for-profit or not-for-profit business, regardless of location, that employs one or more persons that qualify as a “New Mexico Employee”. (See below.) “Evaluation Committee" means a body appointed to perform the evaluation of Offerors’ proposals. “Evaluation Committee Report" means a report prepared by the Procurement Manager and the Evaluation Committee for contract award. It will contain written determinations resulting from the procurement. 9 “Finalist” means an Offeror who meets all the mandatory specifications of this Request for Proposals and whose score on evaluation factors is sufficiently high to merit further consideration by the Evaluation Committee. “Fraud” means an intentional deception or misrepresentation made by an entity or person with the knowledge that the deception could result in some unauthorized benefit to himself or to some other previously described entity or person. It includes any act that constitutes fraud under applicable federal or state law. “HIPAA” means the Health Insurance Portability and Accountability Act of 1996. “Human Services Department (HSD)” means the sole executive department in New Mexico responsible for the administration of Title XIX (Medicaid). “HSD” may also indicate the Agency’s designee, as applicable. To be referred to as Health Care Authority (HCA) effective July 1, 2024. “IT” means Information Technology. “Managed Care Organization (MCO)” means an organization licensed to manage, coordinate and assume financial risk on a capitated basis for the delivery of specified services to enrolled members from a certain geographic area. Also referred to as a managed care plan and managed care program. “Mandatory" – the terms "must", "shall", "will", "is required", or "are required", identify a mandatory item or factor. Failure to meet a mandatory item or factor will result in the rejection of the Offeror’s proposal. “Minor Technical Irregularities” means anything in the proposal that does not affect the price quality and quantity or any other mandatory requirement. “New Mexico Employee” means anyone performing the majority of their work within the State of New Mexico, for any employer regardless of the location of the employer’s office or offices. “Offeror" is any person, corporation, or partnership who chooses to submit a proposal. “PED” means the New Mexico Public Education Department. “Performance Measurement (PM)” means data specified by the state that enables performance to be determined. “Price Agreement" means a definite quantity contract or indefinite quantity contract which requires the contractor to furnish items of tangible personal property, services or construction to a state agency or a local public body which issues a purchase order, if the purchase order is within the quantity limitations of the contract, if any. 10 “Procurement Manager” means any person or designee authorized by a state agency or local public body to enter into or administer contracts and make written determinations with respect thereto. “Procuring Agency" means all State of New Mexico agencies, commissions, institutions, political subdivisions and local public bodies allowed by law to entertain procurements. “Project” means a temporary process undertaken to solve a well-defined goal or objective with clearly defined start and end times, a set of clearly defined tasks, and a budget. The project terminates once the project scope is achieved and project acceptance is given by the project executive sponsor. “Prospective” means a period of time starting with the date of application going forward. “Quality Assurance” means a process of discovery, both prospective and retrospective to evaluate the program; identifies areas for remediation; and implements quality improvement strategies to ensure that appropriate and timely action is taken, as indicated. “Redacted” means a version/copy of the proposal with the information considered confidential as defined by NMAC 1.4.1.45 and defined herein and outlined in Section II.C.8 of this RFP blacked out BUT NOT omitted or removed. “Request for Proposals (RFP)" means all documents, including those attached or incorporated by reference, used for soliciting proposals. “Requirements” are obligatory and mean the system functions that are related to the organization’s goals and business opportunities. Requirements are defined by the project team and are usually prioritized. “Responsible Offeror" means an Offeror who submits a responsive proposal and who has furnished, when required, information and data to prove that his financial resources, production or service facilities, personnel, service reputation and experience are adequate to make satisfactory delivery of the services, or items of tangible personal property described in the proposal. “Responsive Offer" means an offer which conforms in all material respects to the requirements set forth in the request for proposals. Material respects of a request for proposals include, but are not limited to price, quality, quantity, or delivery requirements. “RMS” means Random Moment Sample. “Sealed” means, in terms of a non-electronic submission, that the proposal is enclosed in a package which is completely fastened in such a way that nothing can be added or removed. Open packages submitted will not be accepted except for packages that may have been damaged by the delivery service itself. The State reserves the right, however, to accept or reject packages where there may have been damage done by the delivery service itself. Whether a package has been damaged by the delivery service or left unfastened and should or should not be accepted is a determination to be made by the Procurement Manager. By 11 submitting a proposal, the Offeror agrees to and concurs with this process and accepts the determination of the Procurement Manager in such cases. “Solicitations” means Invitations to Bid (ITBs) and Requests for Proposals (RFPs). “Staff" means any individual who is a full-time, part-time, or an independently contracted employee with the Offerors’ company. “State (the State)” means the State of New Mexico. “State Agency” means any department, commission, council, board, committee, institution, legislative body, agency, government corporation, educational institution or official of the executive, legislative or judicial branch of the government of this state. “State agency” includes the Purchasing Division of the General Services Department and the state purchasing agent but does not include local public bodies. “State plan” means a statewide plan for Medicaid services submitted for approval to CMS under Title XIX of the federal Social Security Act. “Statement of Concurrence” means an affirmative statement from the Offeror to the required specification agreeing to comply and concur with the stated requirement(s). This statement shall be included in Offerors proposal. (E.g. “We concur”, “Understands and Complies”, “Comply”, “Will Comply if Applicable” etc.) “Subcontract” means a written agreement between a contractor and a third party or between a subcontractor and another subcontractor, to provide services. “Subcontractor” means a third party who contracts with a contractor or a subcontractor for the provision of services. “UNM” means the University of New Mexico. “Unredacted” means a version/copy of the proposal containing all complete information including any that the Offeror would otherwise consider confidential, such copy for use only for the purposes of evaluation. “Written” means typewritten on standard 8 1⁄2 x 11-inch paper. Larger paper is permissible for charts, spreadsheets, etc. F. PROCUREMENT LIBRARY A procurement library has been established. Offerors are encouraged to review the material contained in the Procurement Library by selecting the link provided in the electronic version of this document through your own internet connection or by contacting the Procurement Manager and scheduling an appointment. The library contains information listed below: 12 Procurement Regulations and Request for Proposal – RFP instructions: https://www.generalservices.state.nm.us/state-purchasing/resources-and- information/#BestValueProcurementGuide. No one at the Agency other than the Procurement Manager will answer any questions about any materials in the Procurement Library. Offerors are also encouraged to use the Agency website for additional information. 1. Medical Assistance Division Program Policy Manual (See Chapters 300 & 302). Available on website:http://www.hsd.state.nm.us/providers/rules-nm-administrative- code/ 2. Description of New Mexico Medicaid Eligibility Categories. Available on website: https://www.hsd.state.nm.us/wp-content/uploads/MAD-222-2023-2024-1.pdf 3. Procurement Code NMSA 1978, Section 13. Available on website: https://nmonesource.com/nmos/nmsa/en/item/4378/index.do#!fragment/zoupio- _Toc157178777/BQCwhgziBcwMYgK4DsDWszIQewE4BUBTADwBdoAvbRABwE tsBaAfX2zgEYBWAdg54AcPYQEoANMmylCEAIqJCuAJ7QA5KrERCYXAnmKV6 zdt0gAynlIAhFQCUAogBl7ANQCCAOQDC9saTAARtCk7CIiQA 4. Procurement Regulations, NMAC 1.4.1. A copy may be obtained from the following web site address: https://www.generalservices.state.nm.us/wp-content/uploads/Procurement- Code-Regulations-Chapter-4-Part-1.pdf 5. Health Care Authority Medicaid Administrative Claiming Guides https://www.hsd.state.nm.us/lookingforinformation/open-rfps/ 6. Health Care Authority contracts with State Agencies https://www.hsd.state.nm.us/lookingforinformation/open-rfps/ II. CONDITIONS GOVERNING THE PROCUREMENT This section of the RFP contains the schedule, description and conditions governing the procurement. A. SEQUENCE OF EVENTS The Procurement Manager will make every effort to adhere to the following schedule: Action Responsibility Date* 1 Issue of RFP HSD February 14, 2024 2 Deadline for Submission of Acknowledgement of Receipt Form Potential Offerors February 20, 2024 3 Pre-Proposal Conference HSD February 20, 2024 4 Deadline to Submit Additional Questions by Email Potential Offerors February 22, 2024 https://www.generalservices.state.nm.us/state-purchasing/resources-and-information/#BestValueProcurementGuide https://www.generalservices.state.nm.us/state-purchasing/resources-and-information/#BestValueProcurementGuide http://www.hsd.state.nm.us/providers/rules-nm-administrative-code/ http://www.hsd.state.nm.us/providers/rules-nm-administrative-code/ https://www.hsd.state.nm.us/wp-content/uploads/MAD-222-2023-2024-1.pdf https://www.hsd.state.nm.us/wp-content/uploads/MAD-222-2023-2024-1.pdf https://nmonesource.com/nmos/nmsa/en/item/4378/index.do#!fragment/zoupio-_Toc157178777/BQCwhgziBcwMYgK4DsDWszIQewE4BUBTADwBdoAvbRABwEtsBaAfX2zgEYBWAdg54AcPYQEoANMmylCEAIqJCuAJ7QA5KrERCYXAnmKV6zdt0gAynlIAhFQCUAogBl7ANQCCAOQDC9saTAARtCk7CIiQA https://nmonesource.com/nmos/nmsa/en/item/4378/index.do#!fragment/zoupio-_Toc157178777/BQCwhgziBcwMYgK4DsDWszIQewE4BUBTADwBdoAvbRABwEtsBaAfX2zgEYBWAdg54AcPYQEoANMmylCEAIqJCuAJ7QA5KrERCYXAnmKV6zdt0gAynlIAhFQCUAogBl7ANQCCAOQDC9saTAARtCk7CIiQA https://nmonesource.com/nmos/nmsa/en/item/4378/index.do#!fragment/zoupio-_Toc157178777/BQCwhgziBcwMYgK4DsDWszIQewE4BUBTADwBdoAvbRABwEtsBaAfX2zgEYBWAdg54AcPYQEoANMmylCEAIqJCuAJ7QA5KrERCYXAnmKV6zdt0gAynlIAhFQCUAogBl7ANQCCAOQDC9saTAARtCk7CIiQA https://nmonesource.com/nmos/nmsa/en/item/4378/index.do#!fragment/zoupio-_Toc157178777/BQCwhgziBcwMYgK4DsDWszIQewE4BUBTADwBdoAvbRABwEtsBaAfX2zgEYBWAdg54AcPYQEoANMmylCEAIqJCuAJ7QA5KrERCYXAnmKV6zdt0gAynlIAhFQCUAogBl7ANQCCAOQDC9saTAARtCk7CIiQA https://www.generalservices.state.nm.us/wp-content/uploads/Procurement-Code-Regulations-Chapter-4-Part-1.pdf https://www.generalservices.state.nm.us/wp-content/uploads/Procurement-Code-Regulations-Chapter-4-Part-1.pdf https://www.hsd.state.nm.us/lookingforinformation/open-rfps/ https://www.hsd.state.nm.us/lookingforinformation/open-rfps/ 13 5 Response to Written Questions/RFP Amendments Procurement Manager February 28, 2024 6 Deadline for Submission of Proposal Offerors March 14, 2024 7 Proposal Evaluation Evaluation Committee March 18 – 29, 2024 8 Selection of Finalists Evaluation Committee March 29, 2024 9 Best and Final Offers from Finalists Offerors April 5, 2024 10 Oral Presentations and/or Product Demonstrations by Finalists Offerors April 15 -16, 2024 11 Finalize Contract HSD/Offeror April 19, 2024 12 Contract Award HSD May 1, 2024 13 Protest Deadline Other Offerors 15 Days after the Contract Award 14 Effective Date of Contract (Approximate) HSD July 1, 2024 *All dates except items one (1) and six (6) are approximate. The Procurement Manager will make every effort to adhere to the following schedule but reserves the right to change the schedule at her discretion. B. EXPLANATION OF EVENTS The following paragraphs describe the activities listed in the sequence of events shown in Section II. A., above. 1. Issuance of RFP This RFP is being issued on behalf of the New Mexico Health Care Authority stated in Section II. A., SEQUENCE OF EVENTS. https://www.hsd.state.nm.us/lookingforinformation/open-rfps/. 2. Acknowledgement of Receipt Potential Offerors should hand deliver, return by electronic mail, or registered or certified mail the "Acknowledgement of Receipt of Request for Proposals Form" that accompanies this document, Appendix A, to have their organization placed on the procurement distribution list. The form should be signed by an authorized representative of the organization, dated and returned to the Procurement Manager by 3:00 pm MST or MDT stated in Section II. A., SEQUENCE OF EVENTS. The procurement distribution list will be used for the distribution of written responses to questions. Failure to return the Acknowledgement of Receipt form shall constitute a presumption of receipt and rejection of the RFP, and the potential Offeror’s organization name shall not appear on the distribution list. https://www.hsd.state.nm.us/lookingforinformation/open-rfps/ 14 3. Pre-Proposal Conference A pre-proposal conference will be held as indicated in the sequence of events beginning at 1:30 PM MST or MDT at the following location: Medical Assistance Division 1 Plaza la Prensa Santa Fe, NM 87507 Microsoft Teams will also be available. Below is the Microsoft Teams link: Microsoft Teams meeting Join on your computer, mobile app or room device Click here to join the meeting Meeting ID: 230 206 813 367 Passcode: o8TLmz Download Teams | Join on the web Or call in (audio only) +1 505-312-4308,,499208259# United States, Albuquerque Phone Conference ID: 499 208 259# Find a local number | Reset PIN Potential Offeror(s) are encouraged to submit written questions in advance of the conference to the Procurement Manager (see Section I, Paragraph D). The identity of the organization submitting the question(s) will not be revealed. Additional written questions may be submitted at the conference. All written questions will be addressed in writing on the date listed in the Sequence of Events. A public log will be kept of the names of potential Offeror(s) that attended the pre-proposal conference. Attendance at the pre-proposal conference is highly recommended, but not a prerequisite for submission of a proposal. 4. Deadline to Submit Written Questions Potential Offerors may submit written questions to the Procurement Manager as to the intent or clarity of this RFP until 4:00 PM MST or MDT stated in Section II. A., SEQUENCE OF EVENTS. All written questions must be addressed to the Procurement Manager as declared in Section I, Paragraph D. Questions shall be clearly labeled and shall cite the Section(s) in the RFP or other document which form the basis of the question. 5. Response to Written Questions Written responses to written questions will be distributed as indicated in the sequence of events to all potential Offerors whose organization name appears on the procurement distribution list. An e-mail copy will be sent to all Offeror’s that provide Acknowledgement of Receipt Forms described in II.B.2 before the deadline. https://teams.microsoft.com/l/meetup-join/19%3ameeting_ZTE2YjQ1ZjgtOGI4NS00ZmQ2LTkzNWUtMTc1MzM2ZjY3MzJm%40thread.v2/0?context=%7b%22Tid%22%3a%2204aa6bf4-d436-426f-bfa4-04b7a70e60ff%22%2c%22Oid%22%3a%22ae9bb2d7-9798-4008-9e8a-95e8d6e550b5%22%7d https://www.microsoft.com/en-us/microsoft-teams/download-app https://www.microsoft.com/microsoft-teams/join-a-meeting tel:+15053124308,,499208259#%20 https://dialin.teams.microsoft.com/98f048cd-2ec3-451d-8c98-61cc344bd4c7?id=499208259 https://dialin.teams.microsoft.com/usp/pstnconferencing 15 6. Submission of Proposal ALL OFFEROR PROPOSALS MUST BE RECEIVED FOR REVIEW AND EVALUATION BY THE PROCUREMENT MANAGER OR DESIGNEE NO LATER THAN 3:00 PM MST or MDT stated in Section II. A., SEQUENCE OF EVENTS. PROPOSALS RECEIVED AFTER THIS DEADLINE WILL NOT BE ACCEPTED. The date and time of receipt will be recorded on each proposal. If an Offeror decides to use a third-party delivery entity to submit its proposal, it is still the responsibility of the Offeror to ensure that the delivery is made on time. An Offeror should consider all factors regarding the delivery by the third-party entity and ensure that the delivery is made prior to the stated deadline. Proposals will be time- stamped in the system when the Offeror clicks “OK” after “Review and Submit.” Such electronic submissions will be considered sealed in accordance with statute. Proposals must be submitted electronically through the Health Care Authority Procurement Portal. Refer to Section III.B.1 for instructions. Proposals submitted by facsimile, or other electronic means other than through the Health Care Authority electronic procurement portal, will not be accepted. A public log will be kept of the names of all Offeror organizations that submitted proposals. Pursuant to NMSA 1978, § 13-1-116, the contents of proposals shall not be disclosed to competing potential Offerors during the negotiation process. The negotiation process is deemed to be in effect until the contract is awarded pursuant to this Request for Proposals. Awarded in this context means the final required state agency signature on the contract(s) resulting from the procurement has been obtained. 7. Proposal Evaluation An Evaluation Committee will perform the evaluation of proposals. This process will take place as indicated in the sequence of events, depending upon the number of proposals received. During this time, the Procurement Manager may initiate discussions with Offerors who submit responsive or potentially responsive proposals for the purpose of clarifying aspects of the proposals. However, proposals may be accepted and evaluated without such discussion. Discussions SHALL NOT be initiated by the Offerors. 8. Selection of Finalists The Evaluation Committee will select, and the Procurement Manager will notify the finalist Offerors as per schedule Section II. A., SEQUENCE OF EVENTS or as soon as possible. Only Finalists will be invited to participate in the subsequent steps of the procurement. A schedule for the oral presentation and demonstration will be determined at this time. 9. Best and Final Offers Finalist Offerors may be asked to submit revisions to their proposals for the purpose of obtaining best and final offers as per schedule stated in Section II. A., SEQUENCE 16 OF EVENTS. or as soon as possible. Best and final offers may also be clarified and amended at finalist Offeror’s oral presentation and demonstration. 10. Oral Presentations Finalist Offerors will be required to demonstrate their product and respond to Evaluation Committee questions at a location to be determined as per schedule Section II. A., SEQUENCE OF EVENTS or as soon as possible. The Agency reserves the right to extend the time at its sole discretion. All oral presentations will be held in Santa Fe, New Mexico. Finalist offerors will be limited to duration of presentation of not more than two (2) hours. 11. Finalize Contractual Agreements Any Contractual agreement(s) resulting from this RFP will be finalized with the most advantageous Offeror(s) as per schedule stated in Section II. A., SEQUENCE OF EVENTS or as soon thereafter as possible. This date is subject to change at the discretion of the State Purchasing Division or relevant Agency Procurement office. In the event mutually agreeable terms cannot be reached with the apparent most advantageous Offeror in the time specified, the State reserves the right to finalize a contractual agreement with the next most advantageous Offeror(s) without undertaking a new procurement process. 12. Contract Awards After review of the Evaluation Committee Report and the signed contractual agreement, the Agency Procurement office will award as per the schedule in Section II. A., SEQUENCE OF EVENTS or as soon as possible thereafter. This date is subject to change at the discretion of the State Purchasing Division or relevant Agency Procurement office. The contract shall be awarded to the Offeror (or Offerors) whose proposals are most advantageous to the State of New Mexico and the Health Care Authority, taking into consideration the evaluation factors set forth in this RFP. The most advantageous proposal may or may not have received the most points. The award is subject to appropriate Department and State approval. 13. Protest Deadline Any protest by an Offeror must be timely and in conformance with NMSA 1978, § 13- 1-172 and applicable procurement regulations. As a Protest Manager has been named in this Request for Proposals, pursuant to NMSA 1978, § 13-1-172, ONLY protests delivered directly to the Protest Manager in writing and in a timely fashion will be considered to have been submitted properly and in accordance with statute, rule and this Request for Proposals. The 15-calendar day protest period shall begin on the day following the award of contracts and will end at 5:00 pm Mountain Standard Time/Daylight Time on the 15th day. Protests must be written and must include the name and address of the protestor and the request for proposal number. It must also 17 contain a statement of the grounds for protest including appropriate supporting exhibits and it must specify the ruling requested from the party listed below. The protest must be delivered to: Office of General Counsel 1474 Rodeo Road Santa Fe, New Mexico 87505 Protests received after the deadline will not be accepted. C. GENERAL REQUIREMENTS 1. Acceptance of Conditions Governing the Procurement Potential Offerors must indicate their acceptance of the Conditions Governing the Procurement section in the letter of transmittal. Submission of a proposal constitutes acceptance of the Evaluation Factors contained in Section V of this RFP. 2. Incurring Cost Any cost incurred by the potential Offeror in preparation, transmittal, and/or presentation of any proposal or material submitted in response to this RFP shall be borne solely by the Offeror. Any cost incurred by the Offeror for set up and demonstration of the proposed equipment and/or system shall be borne solely by the Offeror. 3. Prime Contractor Responsibility Any contractual agreement that may result from this RFP shall specify that the prime contractor is solely responsible for fulfillment of all requirements of the contractual agreement with a state agency which may derive from this RFP. The state agency entering into a contractual agreement with a vendor will make payments to only the prime contractor. 4. Subcontractors/Consent The use of subcontractors is allowed. The prime contractor shall be wholly responsible for the entire performance of the contractual agreement whether or not subcontractors are used. Additionally, the prime contractor must receive approval, in writing, from the agency awarding any resultant contract, before any subcontractor is used during the term of this agreement. 5. Amended Proposals An Offeror may submit an amended proposal before the deadline for receipt of proposals. Such amended proposals must be complete replacements for a previously submitted proposal and must be clearly identified as such in the transmittal letter. The Agency personnel will not merge, collate, or assemble proposal materials. 18 6. Offeror’s Rights to Withdraw Proposal Offerors will be allowed to withdraw their proposals at any time prior to the deadline for receipt of proposals. The Offeror must submit a written withdrawal request addressed to the Procurement Manager and signed by the Offeror’s duly authorized representative. The approval or denial of withdrawal requests received after the deadline for receipt of the proposals is governed by the applicable procurement regulations. 7. Proposal Offer Firm Responses to this RFP, including proposal prices for services, will be considered firm for one hundred twenty (120) days after the due date for receipt of proposals or ninety (90) days after the due date for the receipt of a best and final offer, if the Offeror is invited or required to submit one. 8. Disclosure of Proposal Contents A. Proposals will be kept confidential until negotiations and the award are completed by the Agency. At that time, all proposals and documents pertaining to the proposals will be open to the public, except for material that is clearly marked proprietary or confidential. The Procurement Manager will not disclose or make public any pages of a proposal on which the potential Offeror has stamped or imprinted "proprietary" or "confidential" subject to the following requirements: B. Proprietary or confidential data shall be readily separable from the proposal in order to facilitate eventual public inspection of the non-confidential portion of the proposal. C. Confidential data is restricted to: 1. confidential financial information concerning the Offeror’s organization; 2. and data that qualifies as a trade secret in accordance with the Uniform Trade Secrets Act, NMSA 1978 § 57-3A-1 to 57-3A-7. 3. PLEASE NOTE: The price of products offered or the cost of services proposed shall not be designated as proprietary or confidential information. If a request is received for disclosure of data for which an Offeror has made a written request for confidentiality, the Agency shall examine the Offeror’s request and make a written determination that specifies which portions of the proposal should be disclosed. Unless the Offeror takes legal action to prevent the disclosure, the proposal will be so disclosed. The proposal shall be open to public inspection subject to any continuing prohibition on the disclosure of confidential data. 19 9. No Obligation This RFP in no manner obligates the State of New Mexico or any of its Agencies to the use of any Offeror’s services until a valid written contract is awarded and approved by appropriate authorities. 10. Termination This RFP may be canceled at any time and any and all proposals may be rejected in whole or in part when the Agency determines such action to be in the best interest of the State of New Mexico. 11. Sufficient Appropriation Any contract awarded as a result of this RFP process may be terminated if sufficient appropriations or authorizations do not exist. Such terminations will be effected by sending written notice to the contractor. The Agency’s decision as to whether sufficient appropriations and authorizations are available will be accepted by the contractor as final. 12. Legal Review The Agency requires that all Offerors agree to be bound by the General Requirements contained in this RFP. Any Offeror’s concerns must be promptly submitted in writing to the attention of the Procurement Manager. 13. Governing Law This RFP and any agreement with an Offeror which may result from this procurement shall be governed by the laws of the State of New Mexico. 14. Basis for Proposal Only information supplied, in writing, by the Agency through the Procurement Manager or in this RFP should be used as the basis for the preparation of Offeror proposals. 15. Contract Terms and Conditions The contract between an agency and a contractor will follow the format specified by the HCA and contain the terms and conditions set forth in the Sample Contract Appendix C. However, the contracting agency reserves the right to negotiate provisions in addition to those contained in this RFP (Sample Contract) with any Offeror. The contents of this RFP, as revised and/or supplemented, and the successful Offeror’s proposal will be incorporated into and become part of any resultant contract. The HCA discourages exceptions from the contract terms and conditions as set forth in the RFP Sample Contract. Such exceptions may cause a proposal to be rejected as 20 nonresponsive when, in the sole judgment of the Agency (and its evaluation team), the proposal appears to be conditioned on the exception, or correction of what is deemed to be a deficiency, or an unacceptable exception is proposed which would require a substantial proposal rewrite to correct. Should an Offeror object to any of the terms and conditions as set forth in the RFP Sample Contract (APPENDIX C) strongly enough to propose alternate terms and conditions in spite of the above, the Offeror must propose specific alternative language. The Agency may or may not accept the alternative language. General references to the Offeror’s terms and conditions or attempts at complete substitutions of the Sample Contract are not acceptable to the Agency and will result in disqualification of the Offeror’s proposal. Offerors must provide a brief discussion of the purpose and impact, if any, of each proposed change followed by the specific proposed alternate wording. If an Offeror fails to propose any alternate terms and conditions during the procurement process (the RFP process prior to selection as successful Offeror), no proposed alternate terms and conditions will be considered later during the negotiation process. Failure to propose alternate terms and conditions during the procurement process (the RFP process prior to selection as successful Offeror) is an explicit agreement by the Offeror that the contractual terms and conditions contained herein are accepted by the Offeror. 16. Offeror’s Terms and Conditions Offerors must submit with the proposal a complete set of any additional terms and conditions they expect to have included in a contract negotiated with the Agency. Please see Section II.C.15 for requirements. 17. Contract Deviations Any additional terms and conditions, which may be the subject of negotiation (such terms and conditions having been proposed during the procurement process, that is, the RFP process prior to selection as successful Offeror), will be discussed only between the Agency and the Offeror selected and shall not be deemed an opportunity to amend the Offeror’s proposal. 18. Offeror Qualifications The Evaluation Committee may make such investigations as necessary to determine the ability of the potential Offeror to adhere to the requirements specified within this RFP. The Evaluation Committee will reject the proposal of any potential Offeror who is not a Responsible Offeror or fails to submit a responsive offer as defined in NMSA 1978, § 13-1-83 and 13-1-85. 21 19. Right to Waive Minor Irregularities The Evaluation Committee reserves the right to waive minor irregularities. The Evaluation Committee also reserves the right to waive mandatory requirements provided that all of the otherwise responsive proposals failed to meet the same mandatory requirements and the failure to do so does not otherwise materially affect the procurement. This right is at the sole discretion of the Evaluation Committee. 20. Change in Contractor Representatives The Agency reserves the right to require a change in contractor representatives if the assigned representative(s) is (are) not, in the opinion of the Agency, adequately meeting the needs of the Agency. 21. Notice of Penalties The Procurement Code, NMSA 1978, § 13-1-28 through 13-1-199, imposes civil, misdemeanor and felony criminal penalties for its violation. In addition, the New Mexico criminal statutes impose felony penalties for bribes, gratuities and kickbacks. 22. Agency Rights The Agency in agreement with the Evaluation Committee reserves the right to accept all or a portion of a potential Offeror’s proposal. 23. Right to Publish Throughout the duration of this procurement process and contract term, Offerors and contractors must secure from the agency written approval prior to the release of any information that pertains to the potential work or activities covered by this procurement and/or agency contracts deriving from this procurement. Failure to adhere to this requirement may result in disqualification of the Offeror’s proposal or removal from the contract. 24. Ownership of Proposals All documents submitted in response to the RFP shall become property of the State of New Mexico. 25. Confidentiality Any confidential information provided to, or developed by, the contractor in the performance of the contract resulting from this RFP shall be kept confidential and shall not be made available to any individual or organization by the contractor without the prior written approval of the Agency. 22 The Contractor(s) agrees to protect the confidentiality of all confidential information and not to publish or disclose such information to any third party without the procuring Agency's written permission. 26. Electronic Mail Address Required A large part of the communication regarding this procurement will be conducted by electronic mail (e-mail). Offeror must have a valid e-mail address to receive this correspondence. (See also Section II.B.5, Response to Written Questions). 27. Use of Electronic Versions of this RFP This RFP is being made available by electronic means. In the event of conflict between a version of the RFP in the Offeror’s possession and the version maintained by the agency, the Offeror acknowledges that the version maintained by the agency shall govern. Please refer to the version found on the HCA website: https://www.hsd.state.nm.us/lookingforinformation/open-rfps/ 28. New Mexico Employees Health Coverage A. If the Offeror has, or grows to, six (6) or more employees who work, or who are expected to work, an average of at least 20 hours per week over a six (6) month period during the term of the contract, Offeror must agree to have in place, and agree to maintain for the term of the contract, health insurance for those employees if the expected annual value in the aggregate of any and all contracts between Contractor and the State exceed $250,000 dollars. B. Offeror must agree to maintain a record of the number of employees who have (a) accepted health insurance; (b) decline health insurance due to other health insurance coverage already in place; or (c) decline health insurance for other reasons. These records are subject to review and audit by a representative of the state. C. Offeror must agree to advise all employees of the availability of State publicly financed health care coverage programs by providing each employee with, as a minimum, the following web site link to additional information http://www.bewellnm.com. D. For Indefinite Quantity, Indefinite Delivery contracts (price agreements without specific limitations on quantity and providing for an indeterminate number of orders to be placed against it); these requirements shall apply the first day of the second month after the Offeror reports combined sales (from state and, if applicable, from local public bodies if from a state price agreement) of $250,000. 29. Campaign Contribution Disclosure Form Offeror must complete, sign, and return the Campaign Contribution Disclosure Form, Appendix B, as a part of their proposal. This requirement applies regardless whether a covered contribution was made or not made for the positions of Governor and https://www.hsd.state.nm.us/lookingforinformation/open-rfps/ http://www.bewellnm.com/ 23 Lieutenant Governor or other identified official. Failure to complete and return the signed unaltered form will result in disqualification. 30. Letter of Transmittal Offeror’s proposal must be accompanied by the Letter of Transmittal Form located in Appendix E which must be completed and signed by an individual person authorized to obligate the company. The letter of transmittal MUST: A. Identify the submitting business entity. B. Identify the name, title, telephone, and e-mail address of the person authorized by the Offeror organization to contractually obligate the business entity providing the Offer. C. Identify the name, title, telephone, and e-mail address of the person authorized to negotiate the contract on behalf of the organization (if different than (2) above). D. Identify the names, titles, telephone, and e-mail addresses of persons to be contacted for clarification/questions regarding proposal content. E. Identify sub-contractors (if any) anticipated to be utilized in the performance of any resultant contract award. F. Describe the relationship with any other entity which will be used in the performance of this awarded contract. G. Identify the following with a check mark and signature where required: 1. Explicitly indicate acceptance of the Conditions Governing the Procurement stated in Section II. C.1; 2. Explicitly indicate acceptance of Section V of this RFP; and 3. Acknowledge receipt of any and all amendments to this RFP. H. Be signed by the person identified in para 2 above. 31. Pay Equity Reporting Requirements A. If the Offeror has ten (10) or more employees OR eight (8) or more employees in the same job classification, Offeror must complete and submit the required reporting form (PE10-249) if they are awarded a contract. Out-of-state Contractors that have no facilities and no employees working in New Mexico are exempt if the contract is directly with the out-of-state contractor and fulfilled directly by the out- of-state contractor, and not passed through a local vendor. B. For contracts that extend beyond one (1) calendar year, or are extended beyond one (1) calendar year, Offeror must also agree to complete and submit the required form 24 annually within thirty (30) calendar days of the annual bid or proposal submittal anniversary date and, if more than one hundred eighty (180) days has elapsed since submittal of the last report, at the completion of the contract. C. Should Offeror not meet the size requirement for reporting at contract award but subsequently grows such that they meet or exceed the size requirement for reporting, Offeror must agree to provide the required report within ninety (90) calendar days of meeting or exceeding the size requirement. D. Offeror must also agree to levy these reporting requirements on any subcontractor(s) performing more than 10% of the dollar value of this contract if said subcontractor(s) meets, or grows to meet, the stated employee size thresholds during the term of the contract. Offeror must further agree that, should one or more subcontractor(s) not meet the size requirement for reporting at contract award but subsequently grows such that they meet or exceed the size requirement for reporting, offer will submit the required report, for each such subcontractor, within ninety (90) calendar days of that subcontractor meeting or exceeding the size requirement. 32. Disclosure Regarding Responsibility A. Any prospective Contractor and any of its Principals who enter into a contract greater than sixty thousand dollars ($60,000.00) with any state agency or local public body for professional services, tangible personal property, services or construction agrees to disclose whether the Contractor, or any principal of the Contractor’s company: 1. is presently debarred, suspended, proposed for debarment, or declared ineligible for award of contract by any federal entity, state agency or local public body; 2. has within a three-year period preceding this offer, been convicted in a criminal matter or had a civil judgment rendered against them for: a. the commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a public (federal, state or local) contract or subcontract; b. violation of Federal or state antitrust statutes related to the submission of offers; or c. the commission in any federal or state jurisdiction of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, tax evasion, violation of Federal criminal tax law, or receiving stolen property; 3. is presently indicted for, or otherwise criminally or civilly charged by any (federal state or local) government entity with the commission of any of the offenses enumerated in paragraph A of this disclosure; 25 4. has, preceding this offer, been notified of any delinquent Federal or state taxes in an amount that exceeds $3,000.00 of which the liability remains unsatisfied. Taxes are considered delinquent if the following criteria apply. a. The tax liability is finally determined. The liability is finally determined if it has been assessed. A liability is not finally determined if there is a pending administrative or judicial challenge. In the case of a judicial challenge of the liability, the liability is not finally determined until all judicial appeal rights have been exhausted. b. The taxpayer is delinquent in making payment. A taxpayer is delinquent if the taxpayer has failed to pay the tax liability when full payment was due and required. A taxpayer is not delinquent in cases where enforced collection action is precluded. c. Have within a three-year period preceding this offer, had one or more contracts terminated for default by any federal or state agency or local public body.) B. Principal, for the purpose of this disclosure, means an officer, director, owner, partner, or a person having primary management or supervisory responsibilities within a business entity or related entities. C. The Contractor shall provide immediate written notice to the State Purchasing Agent or other party to this Agreement if, at any time during the term of this Agreement, the Contractor learns that the Contractor’s disclosure was at any time erroneous or became erroneous by reason of changed circumstances. D. A disclosure that any of the items in this requirement exist will not necessarily result in termination of this Agreement. However, the disclosure will be considered in the determination of the Contractor’s responsibility and ability to perform under this Agreement. Failure of the Contractor to furnish a disclosure or provide additional information as requested will render the Offeror nonresponsive. E. Nothing contained in the foregoing shall be construed to require establishment of a system of records in order to render, in good faith, the disclosure required by this document. The knowledge and information of a Contractor is not required to exceed that which is the normally possessed by a prudent person in the ordinary course of business dealings. F. The disclosure requirement provided is a material representation of fact upon which reliance was placed when making an award and is a continuing material representation of the facts during the term of this Agreement. If during the performance of the contract, the Contractor is indicted for or otherwise criminally or civilly charged by any government entity (federal, state or local) with commission of any offenses named in this document the Contractor must provide immediate written notice to the State Purchasing Agent or other party to this Agreement. If it is later determined that the Contractor knowingly rendered an 26 erroneous disclosure, in addition to other remedies available to the Government, the State Purchasing Agent or Central Purchasing Officer may terminate the involved contract for cause. Still further the State Purchasing Agent or Central Purchasing Officer may suspend or debar the Contractor from eligibility for future solicitations until such time as the matter is resolved to the satisfaction of the State Purchasing Agent or Central Purchasing Officer. 33. New Mexico Preferences This procurement does not qualify for the NM Resident Business Preference or the NM Veteran’s Preference because it is partially supported by federal funding from the Centers for Medicare and Medicaid Services. 27 III. RESPONSE FORMAT AND ORGANIZATION Failure to conform to format and organization may lead to disqualification of any submitted proposal. A. NUMBER OF RESPONSES Offerors shall submit only one proposal in response to this RFP. B. NUMBER OF COPIES 1. ELECTRONIC SUBMISSION ONLY Responses (Health Care Authority Procurement Portal, Bonfire Interactive, can be accessed at https://newmexicohsd.bonfirehub.com/portal/?tab=openOpportunities). 2. All vendors must register with the Procurement Portal to log in and submit requested information. 3. Offeror’s proposal must be clearly labeled and numbered and indexed as outlined in Section III.C. Proposal Format. Proposals must be submitted as outlined below. Technical and Cost portions of Offerors proposal must be submitted in separate uploads as indicated below in this section, and must be prominently identified as “Technical Proposal,” or “Cost Proposal,” on the front page of each upload. Offerors must deliver: 1. Technical Proposals – One (1) ELECTRONIC upload must be organized in accordance with Section III, Response Format and Organization, C. All information in the Technical Proposal must be combined into a single file/document for uploading. a. Confidential Information – If Offeror’s proposal contains confidential information as defined in Section I.E and detailed in Section II.C.8.C, Offeror must submit two (2) separate ELECTRONIC technical files: i. One (1) ELECTRONIC version of the requisite proposal as Unredacted (def. Section I.E) version for evaluation purposes; and ii. One (1) Redacted (def. Section I.E) ELECTRONIC version (information blacked out and not omitted or removed) for the public file, in order to facilitate eventual public inspection of the non- confidential version of the Offeror’s proposal. Redacted versions must be clearly marked as “REDACTED” or “CONFIDENTIAL” on the first page of the electronic file. Technical Proposal must be combined into a single file/document for uploading. https://newmexicohsd.bonfirehub.com/portal/?tab=openOpportunities%20 28 EXCEPTION: Single electronic files that exceed 50mb may be submitted as multiple uploads, which must be the least number of uploads necessary to fall under the 50mb limit. The Technical Proposals SHALL NOT contain any cost information. 2. Cost Proposals – One (1) ELECTRONIC upload of the proposal containing ONLY the Cost Proposal. All information for the cost proposal must be combined into a single file/document for uploading. For technical support issues go to Support@GoBonfire.com or visit their help desk forum at https://bonfirehub.zendesk.com/hc. The ELECTRONIC proposal submission must be fully uploaded in Health Care Authority e-Procurement Portal by the submission deadline in Section II.B.6. Any proposal that does not adhere to the requirements of this Section and Section III.C.1 Response Format and Organization, may be deemed non-responsive and rejected on that basis. C. PROPOSAL FORMAT The mandatory requirement section shall be organized and indexed in the following format and shall contain, as a minimum, all items listed below in the sequence indicated. 1. Proposal Content and Organization Direct reference to pre-prepared or promotional material may be used if referenced and clearly marked. Promotional material should be minimal. The proposal must be organized and indexed in the following format and must contain, at a minimum, all listed items in the sequence indicated. Technical Proposal - DO NOT INCLUDE ANY COST INFORAMTION IN THE TECHNICAL PROPOSAL. A. Signed Letter of Transmittal B. Table of Contents C. Proposal Summary D. Response to Contract Terms and Conditions E. Offeror’s Additional Terms and Conditions F. Response to Specifications (except cost information which shall be included in Cost Proposal only) A. Organizational Experience B. Organizational References C. Other Administrative Responsibilities D. Quality Assurance and Program Integrity E. Medicaid Random Moment Sampling mailto:Support@GoBonfire.com https://bonfirehub.zendesk.com/hc 29 F. Medicaid Administrative Claiming G. Information Systems Capacity and Reports H. Customer Service I. CYFD Title IV-E Random Moment Sampling J. CYFD Title IV-E Claiming K. Financial Stability L. New Mexico Preferences (If applicable) G. Signed Campaign Contribution Form H. Suspension and Debarment Requirement Form I. Other Supporting Material (If applicable) Cost Proposal: 1. Completed Cost Response Form Within each section of the proposal, Offerors should address the items in the order indicated above. All forms provided in this RFP must be thoroughly completed and included in the appropriate section of the proposal. All discussion of proposed costs, rates or expenses must occur ONLY on the cost response form. The proposal summary may be included by potential Offerors to provide the Evaluation Committee with an overview of the proposal; however, this material will not be used in the evaluation process unless specifically referenced from other portions of the Offeror’s proposal. 2. Letter of Transmittal Offeror’s proposal must be accompanied by the Letter of Transmittal Form located in Appendix E which must be completed and signed by an individual person authorized to obligate the company. 3. Table of Contents The table of contents must contain a list of all sections of the proposal and the corresponding page numbers. 4. Proposal Summary The proposal summary must be five (5) pages or less. It shall provide the Evaluation Committee with an overview of the technical and business features of the proposal. This material will not be used in the evaluation process but may be used in public notifications regarding the successful offeror’s selection. 5. Response to Department’s Terms and Conditions The offeror shall explicitly indicate acceptance of the General Requirements (Section II.C) and the Contract Terms and Conditions (Appendix C). As provided in Section II.C.15, should the offeror object to any of the Agency’s terms and conditions, as 30 contained in Appendix C, the offeror must propose specific alternate language. The offeror must provide a brief discussion of the purpose and impact, if any, of each proposed change followed by the specific proposed alternate wording. 6. Offeror’s Additional Terms and Conditions Offerors must submit with the proposal a complete set, in writing, of any additional terms and conditions they request to have included in a contract negotiated with the Department. 7. Response to Mandatory Specifications The Mandatory Specifications may be found in Section IV of the RFP. This section contains information required in the submission of proposals. Offerors must respond in the form of a thorough narrative to each numbered requirement in the order in which they appear in this section. The offeror must identify, in full, the question being answered and its response to that question. 8. Campaign Contribution Disclosure Form The Offeror must complete an unaltered Campaign Contribution Disclosure Form and submit a signed copy with the Offeror’s proposal. This must be accomplished whether or not an applicable contribution has been made. (See Appendix B) 9. Suspension and Debarment Requirement Form The offeror must complete the certification form in Appendix G to certify compliance with federal regulations relating to suspension and debarment. 10. Lobbying No federal appropriated funds can be paid or will be paid, by or on behalf of the CONTRACTOR, or any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any Federal contract, or the making of any Federal grant, the making of any federal loan, the entering into of any cooperative agreement, or modification of any Federal contract, grant, loan, or cooperative agreement. If any funds other than federal appropriated funds have been paid or will be paid to any person influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection of this federal contract, grant, loan, or cooperative agreement, the CONTRACTOR shall complete and submit Standard Form LLL, “Disclosure Form to Report Lobbying,” in accordance with its instructions. 31 IV. SPECIFICATIONS Offerors should respond in the form of a thorough narrative to each specification, unless otherwise instructed. The narratives, including required supporting materials will be evaluated and awarded points accordingly. A. SUMMARY SCOPE OF WORK 1. Performance Measures The HCA has established a strong foundation for promoting and monitoring quality and access. A. Goals 1. Leverage purchasing power and partnerships to create innovative policies and models of comprehensive health care coverage that improve the health and well- being of New Mexicans and the workforce. 2. Achieve health equity by addressing poverty, discrimination, and lack of resources, building a New Mexico where everyone thrives. 3. Implement innovative technology and data-driven decision-making to provide unparalleled, convenient access to services and information. 4. Build the best team in state government by supporting employees’ continuous growth and wellness B. Objectives 1. Select a Contractor to perform quarterly Random Moment Time Sampling (RMS) of New Mexico (NM) State Agencies; 2. Collect NM State Agencies financial information for calculation of quarterly administrative claiming invoices for Medicaid reimbursement. Generate and review final administrative claiming invoices to provide NM State Agencies with Medicaid reimbursement for their allowable administrative expenses in support of the Medicaid program. 3. Collect CYFD financial information for generation of claim data for Title IV-E Reimbursement for allowable administrative expenses in support of the Title IV-E program. 4. Provide support to HCA for training of Skilled Professional Medical Personnel (SPMP) staff in appropriate claiming of administrative activities in support of the Medicaid program. C. Activities This effort will be completed through the various activities listed below: 1. Collect the Participant List to enable the quarterly reporting of allowable NM State Agencies staff whose activities will be surveyed by the RMS. 2. Administer RMS of activities of staff to enable the measurement of administrative activities that are reimbursable under Medicaid or Title IV-E, in accordance with the approved NM Medicaid Administrative Claiming 32 Implementation Plans/Guides or applicable Public Assistance Cost Allocation Plan (PACAP). 3. Provide specially trained, centrally-coordinated staff under the direction and supervision of the Contractor whose responsibility is to review time study responses and to determine the appropriate CMS-approved time study activity designation for those responses and to calculate time study statistics. 4. Administer Financial Reporting and Administrative Claim calculations to prepare quarterly invoices. This will enable the drawdown of federal Medicaid matching funds from CMS via the CMS-64 for distribution to NM State Agencies or provide Title IV-E claim data to allow draw down of funds from the Administration for Children and Families (ACF) via the CB-496 for distribution to CYFD. 5. Provide HCA and NM State Agencies with management reports, time study compliance monitoring, and management and post-claiming quality assurance and review to assist in assuring program integrity. 6. Provide training for HCA Skilled Professional Medical Personnel (SPMP) staff in appropriate claiming of administrative activities for claiming enhanced federal Medicaid match for allowable activities. 7. Perform all the above consistent with the HCA, CYFD, CMS and ACF operational and security policies. B. TECHNICAL SPECIFICATIONS Offerors should respond in the form of a thorough narrative to each of the numbered mandatory specifications. The narratives along with required supporting materials will be evaluated and awarded points accordingly. Failure to respond to Mandatory Specifications will result in the disqualification of the proposal as non-responsive. 1. Organizational Experience General Expectations: The offeror will: • Perform Random Moment Sampling (RMS) and Administrative Claiming for New Mexico State Agencies participating in the Medicaid Program. • Perform all work associated with this contract in the United States. • Employ sufficient staff as required to ensure completion of all RMS and/or Administrative Claiming responsibilities in accordance with established timelines. • Maintain a level of work performance consistent with high professional standards in the industry. All employees assigned to perform work relating to this contract will be capable, efficient and no less qualified than other employees of the contractor performing the same or similar work. 33 Mandatory Requirements: 1. Submit a statement of relevant corporate experience within the last five (5) years, including the experience of major subcontractors. 2. Provide the name and address of the offering company/organization and its parent company (if applicable), including any “doing business as” either in New Mexico or in other locations. 3. Provide a table of the organization or organizational chart including an explanation of the functions of the significant operating units within New Mexico and/or in other locations for this contract. 4. Provide documentation describing the offeror’s relationship to parent, affiliated or related business entities including, but not limited to, subsidiaries, joint ventures, or sister corporations. 5. For any of the offeror’s (to include the offeror’s parent organization, affiliates and subsidiaries) contracts listed in #4 above, has the other contracting party notified the offeror that it has found the offeror to be in breach of the contract (failed to meet a contract requirement)? If yes: 6. Please provide a description of the events concerning the breach, specifically addressing the issue of whether or not the breach was due to factors beyond the offeror’s control. 7. Was a corrective action plan (CAP) or its equivalent imposed? If so, describe the steps and timeframes in the CAP and whether the CAP was completed. 8. Was a sanction imposed? If so, please describe the sanction, including the amount of any monetary sanction (e.g., penalty or liquidated damage). 9. Was the breach the subject of an administrative proceeding or litigation? If so, what was the result of the proceeding/litigation? The offeror shall provide the required information for all public sector contracts (including, but not limited to, Medicaid, Medicare, CHIP, and public employees) as well as any non-public sector contracts that cover more than 200,000 lives. 2. Organizational References General Expectations: The offeror will: • Ensure its staff possess sufficient current knowledge of the requirements of this Scope of Work, and the applicable State and Federal regulations Mandatory Specifications: 10. Provide three (3) external corporate references from clients who have received similar services to those proposed for this contract, especially those projects in the public sector that have occurred within the past five (5) years. If the offeror proposes to use subcontractors for significant portions of the scope of work, the offeror shall provide additional three (3) external references for each major subcontractor, if applicable. Offerors are required to submit Appendix F, Organization Reference Questionnaire, to the business references they list. The 34 business references must submit the Reference Form directly to the designee described in Sec I Paragraph D. It is the Offeror’s responsibility to ensure the completed forms are received on or before March 14, 2024, for inclusion in the evaluation process. Organizational References that are not received or are not complete, may adversely affect the vendor’s score in the evaluation process. The Evaluation Committee may contact any or all business references for validation of information submitted. If this step is taken, the Procurement Manager and the Evaluation Committee must all be together on a conference call with the submitted reference so that the Procurement Manager and all members of the Evaluation Committee receive the same information. Additionally, HCA reserves the right to consider any and all information available to it (outside of the Business Reference information required herein), in its evaluation of Offeror responsibility per Section II, Para C.18. Offerors shall submit the following Business Reference information as part of Offer: a) Client name; b) Project description; c) Project dates (starting and ending); d) Technical environment (i.e., Software applications, Internet capabilities, Data communications, Network, Hardware); e) Staff assigned to reference engagement that will be designated for work per this RFP; and f) Client project manager name, telephone number, fax number and e-mail address. 3. Oral Presentation/Product Demonstration If selected as a finalist, HCA will ask the finalists to provide the Evaluation Committee the opportunity to interview all proposed core staff during an oral presentation and review the information systems capabilities at a date, time, and place set by the Procurement Manager. 4. Mandatory Specifications A. Other Administrative Responsibilities General Expectations: The offeror shall: • Demonstrate the flexibility to work with HCA, New Mexico State Agencies and stakeholder groups on the successful implementation of program changes. • Provide HCA with assistance in submitting and negotiating with CMS any required updates to the current Medicaid Administrative Claiming 35 Implementation Plans/Guides. • Coordinate as necessary with HCA and New Mexico State Agencies to assure participant questions are appropriately directed. • Be responsive, and respond within one (1) business day, to HCA and New Mexico State Agencies. • Be expected to function as a partner to HCA and New Mexico State Agencies. This partnership will include avail