Columbia Public Schools Columbia, Missouri

Transcription

1 FOR THE S Columbia Public Schools Columbia, Missouri RFP # C Invitation For Request For Proposal THIRD PARTY ADMINISTRATOR TO MANAGE THE SCHOOL DISTRICT ADMINISTRATIVE CLAIMING and ADMINISTRATION AND DIRECT BILLING OF THE FEE FOR SERVICE MEDICAID PROGRAM Request for Proposal and Guidelines for Submittal ISSUED: October 7, 2009 PROPOSALS DUE ON OR BEFORE: Friday, October 23, 2:00 P.M. Columbia Public Schools Attn: Greg Cooper, Purchasing Agent Business Services Building 916 Bernadette Drive Columbia, MO 65203

2 PROPOSAL SUBMISSION All Proposers submitting responses must provide four paper copies and one copy on CD in Microsoft Office format in a sealed package with the following information clearly marked on the front of the package: Greg Cooper, Purchasing Agent Business Services Building 916 Bernadette Drive Columbia, MO RE: Medicaid Request for Proposals RFP # C Due on Friday, October 23, 2009 at 2:00 p.m. A team comprised of Columbia Public Schools (CPS) administration personnel shall evaluate all proposals. Vendor selection shall be determined by an evaluation of the total content of the proposal submittal. CPS shall not be obligated to explain the results of the evaluation process to any Vendor. Negotiations, demonstrations, and tests may or may not be entered into or required of bidders submitting proposals, which in the sole judgment of the District are worthy of continued consideration. The District may select the two proposals that best meet our needs and require a presentation of the proposed solution within one week of notification by CPS. Failure to meet this requirement may result in the proposal being rejected.

3 INVITATION RFP No: RFP # C THIRD-PARTY ADMINISTRATOR TO PROCESS CLAIMS AND HANDLE SCHOOL DISTRICT ADMINISTRATIVE CLAIMING AND DIRECT BILLING FOR MEDICAID ELIGIBLE SERVICES, FEE-FOR-SERVICE Date of Issue: 10/7/09 1. Request for Proposals for Third-Party Administrator to manage the administration and direct billing of the fee-for-service Medicaid program and/or services described in Section II Technical Requirement/Scope of Services will be received by the Columbia School District, PURCHASING DEPARTMENT, until the date and time specified below. 2. Due Date: October 23, 2009 Time: 2:00 PM 3. Submittal Location: Business Services Building, 916 Bernadette Drive, Columbia, MO District Contact Person: Greg Cooper, Purchasing Agent, , gcooper@columbia.k12.mo.us 5. All proposals are subject to the following: (checked) (X) Attachment 1 (X) Attachment 2 (X) Attachment 3 (X) Attachment 4 (X) Attachment 5 Signature Section Reference and Experience Form General Questions Cost Proposal No Bid Response 6. To offer a proposal please complete and return all required sheets of this proposal on or before the opening date and time. Late proposals will not be considered and will be returned unopened.

4 I. INTRODUCTION The Columbia Public Schools is a public school district providing special education services to more than 2,400 students with disabilities and in Columbia, Missouri. This document is a formal Request for Proposal (RFP) for a qualified third-party administrator to manage the school district administrative claiming and direct billing of the fee-for-service Medicaid program. The Mo. Healthnet Program reimburses the District for school-based child health services it provides according to the established Mo. Healthnet Medicaid policy. The District is requesting the processing of Medicaid Claims including providing training for district personnel in Medicaid Claims processing and technical consultation. The District s estimated annual Medicaid Claims total is approximately $400,000 - $500,000. The term of awarded contract will be for a one-year period with two 1-year options. After three total years, the contract may go out for bid again and an additional RFP may be issued at that time. Fill in the attachments and forms in this Request for Proposal and responses to the requirements should follow the sequence provided. All proposals submitted must be delivered to the CPS Purchasing Agent before 2:00 p.m. on Friday, October 23, 2009 to be considered for evaluation. Proposals received after this time may not be accepted and may be returned to the vendor unopened. SUMMARY OF KEY DATES: October 7, 2009 October 15, 2009 October 23, 2009 November 9, 2009 November 16, 2009 RFP sent to vendors Written questions via must be submitted by vendors by 3:00 p.m. Proposals Due by 2:00 p.m. at CPS Business Services Building Board of Education meeting to review and approve (tentative) Contract finalization (tentative) Submit all questions and inquiries via to the CPS personnel listed below: Greg Cooper, Purchasing Agent Business Services Building 916 Bernadette Drive Columbia, MO gcooper@columbia.k12.mo.us To ensure equal treatment of all participating Proposers, the name listed above is CPS s only designated representative for this RFP. Proposers are expected to utilize the representative for ALL information regarding this RFP. Proposers, who contact any other District employee or representative of CPS regarding the subject of this RFP, are subject to disqualification from this RFP.

5 II. TECHNICAL REQUIREMENT/ SCOPE OF SERVICES General: The Columbia Public Schools requires the services of a third-party administrator to manage the School District Administrative Claiming (SDAC) and administration and direct billing of the feefor-service Medicaid program. The Mo Healthnet Program reimburses the District for school-based child health services it provides according to its established Mo Healthnet Medicaid policy. The District is requesting the processing of Medicaid Claims including providing training for district personnel in SDAC and Medicaid Claims processing and technical consultation. The District s estimated annual Medicaid Claims total is approximately $400,000 - $500,000. Supplier Responsibilities: The Supplier shall: 1.1 Manage new and existing claims for Medicaid billing and SDAC, upon termination of the current third-party administration agreement, the District shall transfer to the Supplier the responsibility of processing all current claims. 1.2 Review the District's records and identify medical services that were provided to students that can be claimed under the State's existing fee for service program. Update Medicaid eligibility for District students at least bi-monthly. 1.3 The District shall provide vendor with information about students of the School District who are receiving eligible therapies subject to the requirements of the Family Education Rights and Privacy Act (FERPA). 1.4 Prepare and submit on behalf of the District claim forms for Therapies and/or related services provided by CPS professionals to eligible students within the School District and all SDAC materials and claims. 1.5 Claims information prepared by the vendor shall be in the form required by Mo Healthnet for reimbursement of such services. Costs related to filing and processing said claims shall be paid by the vendor. 1.6 Accept both paper copies and electronic files of Medicaid services logs for data entry and SDAC claim forms. Generate physician prescription forms to be used by the District. 1.7 Ensure that appropriate service logs and progress notes are maintained in auditable files and readily accessible in an organized format. 1.8 Demonstrate that it has the capacity to have a Missouri based representative who can provide training and support. 1.9 Provide the District's administrative staff with monthly reports of claims pending, paid, or denied in an Excel format Provide on-site training to CPS staff, as necessary, and provide user manuals. All vendor costs for training and manuals to be included in fee proposal Advise the District on pending legislation and policy changes related to fee-for-service billing and SDAC Provide a designated account representative available 8:00 AM to 5:00 PM Central Standard Time Monday-Friday The designated account representative shall attend meetings held within the State of Missouri, with 24 hours advance notice, at no additional cost to the District Analyze the current billing practices and provide solutions for areas of concern Work with the Mo Healthnet and its billing agent to resolve issues, while keeping the District informed of all discussions.

6 III. GENERAL INSTRUCTIONS 1) QUESTIONS a) Prospective Proposers are urged to read all sections very carefully. All questions must be submitted via to the attention of the Purchasing Manager listed above by October 15, Questions submitted after the deadline will not be answered. Responses to the questions will be provided to all potential vendors. b) Misinterpretation of the specifications by the Proposer shall not relieve the Proposer(s)/contractor(s) of responsibility to perform. 2) PROPOSALS a) Elaborate and expensive copy is not required: neat, legible and clearly stated information is adequate and will be used in the evaluation process. Supplier brochures may be included on an optional basis, but may not be substituted for the information requested herein. i) By submitting a proposal, proposer is agreeing to be bound by all of the specifications herein. ii) Proposals will not be returned. b) Transmittal Letter. i) A transmittal letter prepared on the Proposer s business stationery must accompany the proposal. The purpose of this letter is to formally submit the proposal and it should be brief. Include statements signed by authorized individual representing your firm indicating respondent has read and agrees to terms and conditions set forth in the RFP. ii) The letter must be signed by an authorized individual able to bind the Proposer s firm to all items in the proposal including products, services, prices, etc. contained in the proposal. c) Company History i) The Proposer shall: (1) Complete the Proposer Signature Section which includes potential conflict of interest statement (See Attachment #1) (2) Provide proof that the Proposer has at least one year of successful experience with SDAC and direct billing and is licensed to provide services in the State of Missouri. (3) State if your company is involved in any mergers or acquisitions and explain the specifics. (4) Describe any current or recent (within 1 year) litigation the company is involved in related to Medicaid billing for school districts. If litigation is complete, the results of the litigation must be included.

7 III. GENERAL INSTRUCTIONS (CONTINUED) (5) Briefly describe its company history. The description should include the size (number of employees and/or revenues) and areas of specialization. Provide the same information for the office that would handle CPS s account if the firm has more than one office. (6) Describe any special expertise your firm has in providing requested services to school districts or other public agencies. (7) References: Proposers should provide references. (See Attachment #2). Include a minimum of three references. All references must be current one year or less. CPS reserves the right to contact additional references, which are known to CPS but may not have been provided by the Proposer. (8) Include job titles and description of personnel who will provide services for this contract, if applicable. This should include account executives, training and support personnel and others who would actively work on CPS s account. Be sure to identify the individual within your firm that will have overall responsibility for CPS s account and the office in which each account team member is located. Provide any additional information about the project team. d) The Cost Proposal must contain the following: (See Attachment #4) i) Provide specific fee structure; Firm Fixed and/or Percentage and not subject to change throughout the contract once negotiated for both SDAC and direct Medicaid billing. ii) Proposer should address CPS s out-of-pocket expenses including for any additional software or hardware requirements not included by the proposer. iii) The Proposer shall provide the terms and conditions of the firm s request for payment. 3) CLOSING DATE AND DELIVERY OF PROPOSALS a) The Proposer has the sole responsibility to have the proposal delivered to the specified location by the deadline for proposal submission. b) All expenses for submitting an offer in response to this RFP shall be borne by the Proposer.

8 c) Failure to use the Proposal Submission Form or to fully complete it may result in a declaration that the subject proposal is non-responsive and ineligible for further consideration. d) Late proposals will not be considered. Offers submitted after the proposal submission deadline will be returned to the Proposer unopened, provided that the mandatory proposal identification information is shown on the outside of the proposal envelope. The Proposer will be contacted to arrange for either return (unopened, at submitter's expense) or disposal. e) Vendors not bidding complete No Bid Response (See Attachment #5) IV. CONDITIONS 1) SUPPLIER SELECTION a) Supplier selection shall be determined by an evaluation of the total content of the proposal submitted including satisfying the objectives and requirements detailed in the specifications of Section II. b) CPS reserves the right to require Proposers to demonstrate any hardware or software in their proposal. c) CPS shall not be obligated to explain the results of the evaluation process to any Proposer. d) After considering both the technical and financial factors set forth in this RFP, the committee will make recommendations for the award of the contract to the responsive and responsible Proposer whose proposal is determined to be the most advantageous to CPS. e)after selection, but prior to contract award, the committee reserves the unilateral right to negotiate any aspect of the proposal or proposed contract in any manner that best serves the needs of CPS and is within the scope of the solicitation. Subject to successful negotiations and approval of the Board of Education, a contract or purchase order will be issued to the selected Proposer. 2) FORMATION OF AGREEMENT/CONTRACT WITH SUCCESSFUL PROPOSER a) The contract to be entered into as a result of this RFP shall be by and between the Proposer as contractor and CPS. b) By submitting an offer in response to this solicitation, the Proposer agrees to all terms, conditions and the specification section contained herein, unless and except as otherwise noted as an exception in the Proposer's proposal. c) No verbal agreement or conversation with any officer, agent or employee of CPS either before or after the execution of the contract resulting from the RFP or follow-up negotiations, shall affect or modify any of the terms or obligations contained in the written contract resulting from the RFP. d) No alterations to the terms and conditions of the contract shall be valid or binding unless made in writing and signed by the Purchasing Director and an authorized contractor representative. 3) EXAMINATION OF RECORDS: a) The selected Proposer agrees that in any resulting contract either CPS, or its duly authorized representative, shall have access to, and the right to examine and copy any directly pertinent books, documents, papers, and records of the contractor involving transactions related to any resultant contract. b) This obligation shall expire three years after the final payment for the final service performed because of and all contract(s) awarded pursuant to this solicitation.

9 c) Selected Proposer will provide reasonable access to all necessary documents and upon demand provide copies of documents if so required by CPS or its representative(s). 4) GENERAL: a) The following general information is provided and shall be carefully followed by all Proposers to insure that the proposals are properly prepared. b) Each Proposer must furnish all information required by the RFP. The person signing the proposal must initial erasures or other changes. Proposals signed by an agent of the corporation must be accompanied by evidence of his or her authority. c) CPS reserves the right to conduct discussions with qualified Proposers in any manner necessary to serve the best interest of CPS. d) No Submittal. See Sample letter at end of RFP if your company will not be submitting a proposal. e) Undue Influence. The Proposer shall not, under penalty of law and immediate disqualification of the proposal, offer or give any gratuities, favors or anything of monetary value to an officer, employee, agent, Board of Education member, Governing Council member or Parent Advisory Council member of CPS for the purpose of influencing favorable disposition toward a submitted proposal or for any reason while a proposal is pending or during the bidding process. f) Competition. No Proposer shall engage in any activity or practice, by itself or with other companies, the result of which may be to restrict or eliminate competition or otherwise restrain trade. Violation of this instruction will result in immediate rejection of the Proposer's proposal. g) Withdrawal. Proposals may be modified or withdrawn by written notice or in person by a Proposer or its authorized representative, provided its identity is disclosed on the envelope containing the proposal and such person signs a receipt for the proposal, but only if the withdrawal is made prior to the submission deadline. h) Equal Employment Opportunity. CPS is an equal opportunity employer and does not discriminate on the basis of race, color, gender, age, physical or mental disability, national origin, religion, disabled veteran status or Vietnam era veteran status. i) Disadvantaged/Female Business: CPS hereby notifies all Proposers in regard to any Contract entered into pursuant to this invitation to bid or advertisement of solicitation, that disadvantaged/female business enterprises will be afforded full opportunity to submit bids and/or proposals and will not be subject to discrimination on the basis of race, color, gender, physical or mental disability or national origin in consideration for an award. j) Barred List. By submitting a proposal, the Proposer certifies that it is not currently barred or otherwise prohibited from submitting proposals for contracts to any political subdivision or agency of the State of Missouri and it is not an agent of a person or entity that is currently barred or otherwise prohibited from submitting proposals for contracts by any political subdivision or agency of the State of Missouri. k) Conflict of Interest. The successful Proposer must agree that under no circumstances shall a member, officer or employee of CPS, the Board of Education, or the Governing Council, during his/her tenure and for one year thereafter, be permitted to participate in the Contract, or any part thereof, or to derive any benefits there from.

10 GENERAL (CONTINUED): l) Independent Contractor. It is understood that the successful Proposer is an independent contractor supplying services to CPS. Neither the successful Proposer nor its employees shall represent themselves to be employees, agents, representatives, partners or joint ventures of CPS for any purposes whatsoever. i) The successful Proposer shall comply with all federal, state and local laws, regulations and ordinances, including but not limited to, the compliance with all employment tax requirements for withholding and all applicable state and federal employment and workers' compensation laws. CPS shall not withhold taxes from the successful Proposer s compensation. CPS shall not be construed to be the successful Proposer s employer, nor be held liable for any obligation as an employer. m) Assignment. The Proposer s obligations under the proposal or the Contract shall not be assignable or transferable without the written consent of CPS. n) Tax Exemption. CPS is exempt from the payment of city, state and federal taxes. Such taxes must not be included in the proposal price. o) Proprietary Information. Due regard will be given for the protection of proprietary information contained in all Proposals received. However, vendors should be aware that all materials associated with the procurement are subject to the terms of the Freedom of Information Act (FOIA) and all rules, regulations and interpretations resulting there from. Proposals containing data that the Company does not want used or disclosed for any purpose other than evaluation of the Proposal may be restricted, provided the Company marks the cover sheet of the Proposal with the following legend: Technical data contained on pages and in this Proposal furnished in connection with the Request for Proposals of the Columbia School District shall not be used nor disclosed except for evaluation purposes, provided that, if a Contract is awarded to this Company as a result of or in connection with the submission of this Proposal, The Columbia School District shall have the right to use or disclose technical data to substantiate the award of a Contract. 5) TERMINATION: a) Termination for Cause. The District, in its discretion, may terminate the Contract in whole or in part at any time, whenever it is determined that the successful Proposer has failed to comply with or breached one or more of the terms and conditions of the Contract or specifications incorporated therein and the successful Proposer has failed to correct such failure or breach to the District's satisfaction within a period of fifteen days after receiving written notice thereof from the District. In the event of the partial or total termination of the Contract, it is hereby agreed that the District shall only be obligated to pay in accordance with the terms of the Contract for materials and services that have been accepted the District. b) Termination for Convenience. The District may terminate the Contract without cause by notifying the successful Proposer in writing thirty days prior to the effective date of termination. The successful Proposer shall not incur new obligations after the effective date of termination and shall cancel as many outstanding obligations as possible. c) Termination for Non-Appropriation. In the event the Board of Education of the District fails to approve the appropriation of funds sufficient to provide for the District's obligations under the Contract, or if the funds are not appropriated due to federal, state or local action, the District shall have the right to terminate the Contract, in whole or in part, by providing written notice to

11 the successful Proposer and the District will thereby be relieved from all further obligations under the Contract for all terminated portions. V. DISTRICT RIGHTS 1) REJECTION OF PROPOSALS CPS reserves the right, at its sole discretion, to reject all proposals that it receives because of this RFP. CPS also reserves the right to waive informalities and minor irregularities in those proposals received, and retains the right to negotiate separately with any source whatsoever, in any manner necessary, to serve the best interests of CPS. CPS will, at its discretion, award the contract to the responsible Successful Proposer(s) submitting the best proposal that complies with the RFP. 2) LIABILITY AND RESERVED RIGHTS- INCURRING COSTS a) CPS is not liable for any costs incurred by the Successful Proposer prior to the issuance of any agreements, contracts, or purchase orders, and will not pay for information solicited or obtained in response to this RFP. The information obtained will be utilized solely to determine the suitability of the products or services offered. Subsequent procurement, if any, will be in accordance with appropriate rules and regulations. b) This RFP does not commit CPS to pay any cost incurred in the preparation or submission of any proposal or to procure or contract for any services. CPS reserves the right to amend this RFP by an addendum issued up to five business days prior to the date set for receipt of proposals. Addenda or amendments will be mailed or faxed or ed to all Successful Proposers who have procured copies of the RFP. If revisions are of such a magnitude to warrant, in CPS's opinion, the postponement of the date for receipt of proposals, an addendum will be issued announcing the new date. 3) AWARD TIME CPS contemplates awarding the Contract within ninety calendar days from the Deadline for Proposals. Should the award of the Contract be delayed in whole or in part beyond the ninety calendar day period, such award shall be conditioned upon the Proposer s acceptance. 4) CONTRACT AWARD The Contract will be awarded to that Proposer whose proposal will be most advantageous to CPS based on conformity to the RFP, reputation of the Proposer, cost and other factors. The award will be subject to approval by the Board of Education. 5) JOINT VENTURES Proposals requesting joint ventures between vendors will not be accepted. The District will only enter into a contract with a prime vendor who will be required to assume full responsibility for the delivery/installation of equipment, wiring, software, and related services identified in this RFP whether or not the equipment, products and or services are manufactured, produced or provided by the prime vendor. The prime vendor may enter into written subcontracts for performance of certain of its functions under the contract only with written approval from the District prior to the effective date of any subcontract. The prime vendor shall be wholly responsible for the entire performance of the contract whether or not subcontractors are used.

12 V. DISTRICT RIGHTS (CONTINUED) 6) NEGOTIATION CPS reserves the right to negotiate Contract terms with any, all or none of the final proposals from selected Proposers, CPS shall begin negotiation of the final Contract terms with the Proposer whose proposal is deemed most advantageous by CPS. If negotiation does not result in mutual agreement of terms, CPS may commence negotiations with a second Proposer, and so on. a) CPS reserves the right to recommence negotiations with any Proposer, regardless of whether negotiations have ceased or CPS has commenced negotiations with a second Proposer. b) CPS reserves the right to negotiate final Contract terms with any Proposer, regardless of whether such Proposer was interviewed or submitted a best and final proposal. c) CPS reserves the right to negotiate in an attempt to clarify and qualify terms of any proposal. d) CPS may accept any proposal as submitted whether or not negotiations have been conducted between the parties. e) Neither the commencement nor cessation of negotiations shall constitute rejection of the proposal or a counteroffer on the part of CPS. f) Initial proposals may not be withdrawn for ninety calendar days from the Deadline for Proposals except with the express written consent of CPS. If a proposal is accepted as submitted, the negotiated final Contract shall consist of the Contract, this RFP plus any addenda thereto, and the Proposer s proposal. g) In the event the Contract initially awarded by CPS is terminated for any reason within one hundred twenty days (120) of the Deadline for Proposals, CPS reserves the right to negotiate and accept any other submitted proposal. 7) REJECTION/WAIVER CPS reserves the right to reject any or all proposals and to waive informalities and minor irregularities in proposals received. CPS, in its sole discretion, will determine whether an irregularity is minor. 8) SPECIFIC LIMITATIONS CPS may accept one part, aspect or phase, or any combination thereof, of any proposal unless the Proposer specifically qualifies its offer by stating that the proposal must be taken as a whole. 9) REMOVAL FROM MAILING LISTS CPS reserves the right, in its sole discretion, to remove from mailing lists for future RFP's for an indeterminate period, the name of any Proposer for any reason. 10) REDUCTION IN SCOPE OF WORK In the event CPS decides to make a minor reduction in the scope of the work of the Contract due to a change of conditions, CPS shall notify the successful Proposer of such decision in writing at least thirty days in advance and the Contract amount shall be equitably adjusted. 11) ALTERNATE OFFER CPS reserves the right, in its sole discretion, to accept other than the lowest cost proposal if an alternate proposal is considered to be more advantageous to the District based on factors other than cost.

13 ATTACHMENT #1 SIGNATURE SECTION 1) Designate one individual as the Proposer s representative to CPS during the Contract period. The representative will be contacted to resolve any and all problems that may arise concerning the Contract or proposal. The undersigned Proposer hereby agrees to be bound by the terms of the RFP and that the enclosed proposal is submitted in accordance therewith. Once completed and returned, this proposal becomes the primary basis for evaluation and selection of the Proposer to provide the services required by CPS for the specified Contract period. By signing this proposal, the Proposer certifies that there are no "PARTIES OF INTEREST" or "CONFLICTS OF INTEREST", as defined by state and/or federal regulations, existing between the Proposer and CPS or any of its employees, Board of Education members or Governing Council members. Legal name (Prime contractor) Representative's Name Title Address City/State/Zip Telephone Number Fax Number Address: 2) Years in Operation Years under current structure and/or under previous structure 3) Name of Proposer's officers: NAME TITLE 4) The undersigned hereby acknowledge the receipt of the following addenda: Addendum Number Date Issued Acknowledged Signature 5) Number of Employees: FULL TIME: PART TIME: INDEPENDENT CONTRACTORS:

14 ATTACHMENT #2 REFERENCE AND EXPERIENCE Each Proposer must submit a minimum of three references. Each reference must be presently using the services similar to those requested in this RFP in both quality and quantity. No reference may be an affiliate of the Proposer or the Proposer's officers, directors, shareholders or partners. LIST CURRENT CONTRACTS FOR SCHOOL DISTRICTS, UNIVERSITIES OR SIMILAR ORGANIZATIONS; INCLUDE CONTACTS AND TELEPHONE NUMBERS FOR EACH REFERENCE. USE ADDITIONAL PAGES FOR ADDITIONAL CONTRACTS. 1) Company Name: Business Address: Name/Title of Contact: Phone Number of Contact: Address: Contract Length: Contract Value: 2) Company Name: Business Address: Name/Title of Contact: Phone Number of Contact: Address: Contract Length: Contract Value: 3) Company Name: Business Address: Name/Title of Contact: Phone Number of Contact: Address: Contract Length: Contract Value: Additional Clients)

15 ATTACHMENT #2 REFERENCE AND EXPERIENCE (CONTINUED) All Contracts terminated for default within the last five years should be noted below. Termination for default is defined as notice to stop performance due to Proposer's nonperformance or poor performance. Submit full details of all terminations for default experienced. Columbia School District of Boone County will evaluate the facts and may at its sole discretion reject the Proposer's proposal if the facts discovered indicate that the completion of a Contract resulting from this RFP may be jeopardized by selection of the Proposer. If the Proposer has experienced no such terminations for default in the past five years, so indicate. TERMINATED FEE FOR SERVICE CONTRACTS WITHIN THE LAST THREE YEARS. #1 #2 #3 Company Name Business Address Name of Contact Title of Contact Telephone Number of Contact Contract Length Contract Value

16 ATTACHMENT #3 GENERAL QUESTIONS How are the Random Moments (RMS) completed, electronically or on paper? How is training completed for districts? Is online training available for districts that need it? Has there been a SDAC methodology written and approved by DSS, MHD? If so will it be submitted on the district s behalf? Is the district responsible for submission directly to the state? Does the district or vendor complete the validation of the SDAC random moments? Will the district be provided with a schedule of the RMS at the beginning of the quarter and a list of all completed RMS at the end? Is someone monitoring the RMS to make sure the district participants are completing the moments and who is following up if they are not? What % of SDAC random moments are audited for error? Who performs the audits? Provider Participation Rate: Is this monitored by the vendor for the district? If you have a provider come into your district, is the district responsible for enrolling them through MO HealthNet, or can you notify the vendor for this to be completed? Do you have 100% PPR? If so who is on this page? Do you only use your district number like what was used in the past? If so, how long before that number is deactivated because of inactivity? Medicaid Eligibility Rate: Are your student data files sent through a Secure Site, or are they sent through regular ?

17 If sent through regular who is going to make certain the data is not compromised? When your student data file is uploaded to your FTP account, has it been prepped to make certain you find every eligible student? What is the vendor s HISTORY of SDAC payments? Example: From the time they started the program, when was their first SDAC payment received? How many SDAC quarterly payments are pending at this time for your district? When do you expect payment for these pending quarters? How can the District confirm SDAC invoicing and payments? What method assures vendor billing corresponds with SDAC payment amount? What is the turnaround for vendor billing to District? When the vendor is asked a question ( or phone), what is the turnaround time for an answer?

18 ATTACHMENT #4 COST PROPOSAL The Respondent shall propose pricing in either or both methods. Please list fees for SDAC and Direct Billing separately, designating which fee is for which service. A. a fixed flat monthly fee $ B. a percentage recovery scale $ Submitted by: Name of Company/Contractor Reprensative's Name Title address: Year 1 1 st Option year 2 nd Option year TOTAL

19 ATTACHMENT #5 NO BID RESPONSE Dear Potential Proposer: If your firm elects not to submit the enclosed REQUEST FOR PROPOSAL, please complete the form below and return to my attention. We are sincerely interested in determining why companies/individuals do not respond. Thank you for your help and cooperation. Greg Cooper Purchasing Agent ********************************************************************************** RFP: C SDAC and Medicaid Fee for Service COMPANY NAME: STREET ADDRESS: CITY, STATE, ZIP: PHONE NUMBER: My company has elected not to submit a proposal for this bid for the following reason or reasons: Did not have time to complete bid package Did not receive bid information in time Cannot meet specifications of proposal requirements Not interested in CPS business Cannot be competitive with other traditional sources Other, please indicate reasons(s) below: Please remove from list Signature: