OREGON HEALTH AUTHORITY REQUEST FOR SPECIAL PROCUREMENT 1. Requesting agency name: Oregon Health Authority (OHA) 2. Date of request: May 18, 2014 3. OHA number: 44300 4. OHA contact name: Suzanne Hoffman 5. Phone: 503-569-9545 6. Type of request: Class special procurement Contract-specific special procurement 7. Time period requested: From: June 2014 To: December 2015 8. Total estimated cost: $30,000,000 - $35,000,000 9. Supplies and/or services to be acquired: OHA s Office of Information Services seeks a System Integrator that must transition the Modified Adjusted Gross Income (MAGI) Medicaid eligibility determination engine from Cover Oregon to OHA and facilitate OHA s connection to the Federally Facilitated Marketplace (Healthcare.gov) and its Federal Data Services Hub. 10. Background and proposed contracting procedure: Request: Oregon Health Authority through its Office of Information Services (OIS) requests approval of this Special Procurement to allow for an expedited solicitation process for information technology System Integrator Services. Background: The Oregon Health Authority is at the forefront of lowering and containing costs, improving quality and increasing access to health care in order to improve the lifelong health of Oregonians. OHA includes most of the state's health care programs, including Public Health, Healthy Kids, employee benefits and public-private partnerships and the Oregon Health Plan. This gives the state greater purchasing and market power to begin tackling issues with costs, quality, lack of preventive care and health care access. The Oregon Health Plan (OHP) is Oregon s state Medicaid program. The Health Insurance Association of America describes Medicaid as a government insurance program for persons of all ages whose income and resources are insufficient to pay for health care. It is a means-tested program that is jointly funded by the state and federal governments and managed by the states. The Oregon Health Plan is administered by OHA s Division of Medical Assistance Programs (DMAP). Currently, more than 900,000 people each month receive health care coverage through the Oregon Health Plan.
Oregonians are now able to apply for the Oregon Health Plan or other coverage through Cover Oregon. Cover Oregon is a marketplace where Oregonians can comparison shop for health insurance and see if they qualify for financial assistance to help pay for private insurance. However, the implementation of the Cover Oregon technology was challenging and the Cover Oregon Board has decided to utilize Federally Facilitated Marketplace ( FFM ) technology for 2015 open enrollment period. This decision impacts Oregon s Medicaid Program because the MAGI Medicaid Eligibility determination system that is currently functioning at Cover Oregon must be transitioned to the Oregon Health Authority so that the state can continue to accept and process MAGI Medicaid applications. Because Oregon must be able to receive application files from the FFM on November 15, 2014, the transition of the MAGI Medicaid Eligibility determination system and the connection to the FFM must occur rapidly. Additionally, Oregon s Medicaid program must be able to process, and determine eligibility for MAGI Medicaid applications that come direct to OHA, rather than being processed through the FFM. In order to accept these applications direct at OHA, at minimum a fillable pdf application will be required; however, the state wishes to minimize the amount of manual labor associated with processing these applications, and so more robust technology is preferred. While the MAGI Medicaid Eligibility determination system is working in the Cover Oregon solution, its connection to the OHA solution must be designed, developed, tested and implemented no later than November 15, 2014. It is anticipated that further development of the FFM and MAGI Medicaid Eligibility determination system will occur after the November 15, 2014 and at the option of OHA, it may amend the resulting contract to include that additional development work. Given the time sensitivities associated with this work, the State of Oregon desires to use a System Integrator that has successfully completed similar work (connection of a state Medicaid program to the FFM) in at least one other state. To that end, Oregon sought a list of such firms from the Centers for Medicare and Medicaid Services (CMS). This Special Procurement allows OHA to solicit proposals from a pool of ten (10) firms who have been identified as having competed and been awarded a contract for similar services in other states. The ten (10) firms are: A. Accenture LLP B. Deloitte Consulting LLC C. Engage Point D. HP Enterprises Services, LLC E. KPMG LLP F. Northrop Grumman G. Red Mane Technology H. Social Interest Solutions I. Vertical Build J. Xerox Corporation Note: OHA will only solicit proposals from those firms that desire to participate in this Special Procurement Process. Consequently, OHA may solicit proposals from less than ten (10) firms if any firm informs OHA that it does not wish to participate. Proposed Procedure:
The following is proposed: a) Special Procurement Notice will be issued through Oregon s Procurement Information Network (ORPIN). Notice of this Special Procurement shall serve as advertisement and notice to the vending community. If competition exists in addition to the ten (10) vendors referenced above in this document, OHA may consider including those other proposers in the expedited solicitation. Any such proposer that submits a protest to this Notice must clearly document its capability of providing the Services referenced in this notice, have the required experience and demonstrate its ability to implement Medicaid eligibility and determination and enrollment system including supporting account transfers to and from the Federal Data Service Hub (FDSH) in similar scale to OHA s current need as set forth in Special Procurement OHA-3828-14. The decision to include any other proposers other than the ten (10) already identified will be at the sole discretion of OHA. b) Solicitation: OHA intends to issue an expedited Request for Proposals (RFP) for the services described above and invite the ten (10) firms listed above to participate. In the expedited RFP, OHA will further describe the services to be required, the process for submitting proposals, the evaluation criteria, scoring methodology and the award process. ORPIN will be the official source of information to be shared between OHA and the ten (10) firms invited to participate. c) Solicitation Protest: Due to the short time frames, OHA will not provide a formal solicitation protest period, but will respond to questions and comments from vendors to the entire pool of potential vendors. a) Response Period: Agency intends to grant the ten (10) proposers approximately two weeks to respond to the expedited RFP unless circumstances justify a shorter or longer response time. b) Award: OHA shall select the top ranked proposer and issue Intent to Award a contract to the proposer whose proposal best meets the needs of OHA by June 18th, considering the evaluation process and criteria specified in the expedited RFP. OHA will provide a protest period of seven (7) calendar days after the Notice of Intent to Award has been released. c) The selected proposer and OHA will negotiate a final contract and execute by June 30. d) Contract Period: Any resultant contract shall have available the term including extensions described in this Special Procurement and the expedited RFP. e) At the option of OHA, it may amend or extend the term of the resulting contract to add additional FFM or MAGI Medicaid Eligibility Functionality. 11. Justification for use of special procurement: Describe the circumstances that justify the use of a special procurement. The primary factor that drives this Special Procurement is to meet the requirements of November 15, 2014. Given this very short time frame, this Special Procurement will help OHA in an expeditious manner permitted by the procurement code to engage the global vendor community and very quickly assess the vendors necessary qualifications to meet
the demands of this project, select the best vendor and negotiate a contract. 12. Findings to satisfy the required standards: This proposed special procurement: (a) will be unlikely to encourage favoritism in the awarding of public contracts or to substantially diminish competition for public contracts because: and The approach OHA intends to follow as briefly described in this request for Special Procurement invites ten (10) firms that have been identified as having implemented other states efforts in participation in the FFM. This Special Procurement s expedited approach is not designed to prevent firms from participating but rather is necessary and designed to give OHA and the selected proposer the ability to deliver a complex project before November 15, 2014. (b)(i) will result in substantial cost savings to OHA or to the public because: Requiring firms who have previously completed the work for another state ensures that they have deep understanding of scope of activities, risk and appropriate mitigations, as well as expertise to perform the work. These factors should result in a proposal that is reasonable in a fixed price, deliverable-based contract. Failure to timely accomplish the work will result in additional costs by the state to (a)continue manual processing of applications and (b) potential penalties from the state s federal funding partners. The ability to amend or extend the term of the original contract to include additional FFM or Medicaid Eligibility Determination functionality will leverage the selected vendor s acquired knowledge and system familiarity, thereby avoiding the costs, including procurement related costs, and delays from engaging a new vendor. and (b)(i) Otherwise substantially promotes the public interest in a manner that could not practicably be realized by complying with requirements that are applicable under ORS 279B.055, 279B.060, 279B.065 or 279B.070 or under any rules adopted thereunder: An online insurance marketplace is mandate by the federal Affordable Care Act (ACA) and OHA must comply with these requirements by November 15, 2014. Using the expedited procurement process set forth above for both OHA and vendors to move quickly and cost effectively to implement the required online insurance marketplace. Additionally, this expedited procurement process follows a process similar to the intent and objectives of the Procurement Code and implementing rules.
APPROVED: Via email May 25, 2014 Kirk N. Rhoades, Designated Procurement Officer Oregon Health Authority