GROUP 73008 – HEALTH SERVICESPAGE 1
STATE OF NEW YORKRequest For Information (RFI)
Health Services – QA & UR
The New York State Strategic Sourcing Team is coordinating responses to this RFI on behalf of the Office of General Services (OGS). This RFI is posted on the OGS website:
Issued: July 27, 2012
Submission Deadline: August 10, 2012 12:00 PM EDT
All contacts/inquiries shall be made by email to the following address:
Request for Information – Statewide Email Services Page 1 of 2
GROUP 73008 – HEALTH SERVICESPAGE 1
Table of Contents
1INTRODUCTION
1.1PURPOSE
1.2BACKGROUND
1.3PERTINENT DATES
2HEALTH SERVICES – QUALITY IMPROVEMENT & UTILIZATION REVIEWS
2.1OBJECTIVES OF THIS RFI
3CONTENT AND FORMAT
3.1SUBMISSION OF RESPONSES
3.2GENERAL TERMS
3.3OPTIONAL ROUNDTABLE DISCUSSION
4ADMINISTRATIVE INFORMATION
4.1COMPANY DEMOGRAPHICS
APPENDIX A
I.CATEGORY-SPECIFIC QUESTIONS
II.PRICING
III.M/WBE PARTICIPATION
IV.ADDITIONAL INFORMATION
1INTRODUCTION
1.1PURPOSE
On behalf of the New York State Office of General Services (OGS), the New York State Strategic Sourcing Team (SST) is issuing this Request for Information (RFI) to gain a better understanding of current capabilities from vendors to provide quality improvement and utilization review services related to Medicaid services in New York State. Using the information acquired through this RFI, New York State will review available options and solutions and make a determination regarding future contracting strategies for quality improvements and utilization reviewsof Medicaid services.
This RFI is not a solicitation. No contract can or will be awarded based upon vendor submissions.
Vendors interested in participating in any potential future opportunities are encouraged to respond to this RFI. Vendors should register through the Online Vendor Registration for Bidder Notification Services ( on the New York State Office of General Services website under classification code 85.
1.2BACKGROUND
New York State currently maintains multiple contracts through the New York State Department of Health for quality improvement and utilization review servicesrelated to Medicaid services.
Section 1902 (a)(30)(A) of the Federal Social Security Act (the Act) requires that State Medicaid Agencies provide methods and procedures to safeguard against unnecessary utilization of care and services and to assure "efficiency, economy and quality of care." Under section 1902 (d), a State can contract with a Quality Improvement Organization (QIO) or QIO-like entity to perform medical and utilization review functions required by law. The contracts must be consistent with the Act.
1.3PERTINENT DATES
Milestone / Date and TimeRFI Release Date / July 27, 2012
RFI Response Due Date / August 10, 2012 12:00 PM EDT
Roundtable Session
(For RFI Respondents Only) / TBD- vendors will be notified if OGS exercises this option
2HEALTH SERVICES – QUALITY IMPROVEMENT & UTILIZATION REVIEWS
2.1OBJECTIVES OF THIS RFI
Understand the level of interest and availability of potential vendors that could provide quality improvement and utilization review services to New YorkState.
Gain a more comprehensive understanding of quality improvement organization business models and industrybest practices.
Identify issues, roadblocks and barriers to successful inclusion of additional vendors able to provide quality improvement and utilization review servicesto New York State.
Obtain vendor feedback on M/WBE participation when working with New York State.
3CONTENT AND FORMAT
3.1SUBMISSION OF RESPONSES
In order to facilitate the review of the responses, please provide the information in the exact order as dictated in the RFI. Please enter responses within this document (Section 4.1) and Appendix A directly below each question, maintaining the original formatting of this document and Appendix A. Respondents should answer all questions. If a question cannot be answered, provide a brief explanation as to why the question cannot be answered (e.g., N/A outside the scope of available business offering). Respondents may also submit electronically any existing material or material prepared specifically in response to the RFI which they believe may be of interest or use to the State.
Please rename this document with the following naming convention: NYS HS RFI Vendor Name.doc (.docx format is also acceptable) and submit according to the directions. OGS reserves the right to have follow-up communications with individual vendors who respond to the RFI.
If any of the information in the vendor response is considered confidential, proprietary or a trade secret, it must be clearly indicated on the appropriate page of the vendor response. Release of such materials is governed by the NYS Freedom of Information Law, which in pertinent part requires the requester to provide specific justification as to why disclosure of particular information in the response would cause substantial injury to the competitive position of the vendor.
Please submit your response electronically via email no later than 12PM EDT on Aug. 10, 2012 to the Health Services New York State Strategic Sourcing Team:
3.2GENERAL TERMS
- The State will not be liable for any costs of work performed in the preparation and production of any RFI response. By submitting a response to the RFI, vendor agrees not to make any claims for, or have any right to, damages because of any misunderstanding or misrepresentation of the information, or because of any misinformation or lack of information in the RFI. The responses to the RFI shall become the property of the State of New York.
- Vendors are requested to respond to all questions included in Appendix A. This RFI is issued as a means for collecting market research; solely for information and planning purposes. A response does not bind or obligate the responder or the New York State Office of General Services to any agreement of provision or procurement of services referenced. No contract can or will be awarded based on submissions.
- Since this RFI is designed as a tool to collect information and will not result in a procurement contract for quality improvement services, it does not fall under the requirements of State Finance Law §§139-j and 139-k (the Procurement Lobbying Law) and there is no restricted period.
- Freedom of Information Law and Responses
a)The purpose of New York State's Freedom of Information Law (FOIL), which is contained in Public Officers Law Sections 84-90, is to promote the public's right to know the process of governmental decision making and to grant maximum public access to governmental records.
b)Thus, a member of the public may submit a FOIL request for disclosure of the contents of the responses submitted to the State in response to this RFI. The responses of respondents are subject to disclosure under FOIL. However, pursuant to Section 87(2)(d) of FOIL, a State agency may deny access to those portions of responses which "are trade secrets or submitted to an agency by a commercial enterprise or derived from information obtained from a commercial enterprise and which if disclosed would cause substantial injury to the competitive position of the subject enterprise." Please note that information which you may claim as proprietary, copyrighted or rights reserved is not necessarily protected from disclosure under FOIL.
c)If there is information in your response which you claim meets the definition set forth in Section 87(2) (d), you must so inform us in a letter accompanying your response.
5. The State reserves the right to:
a)Postpone or cancel this RFI upon notification to all RFI respondents.
b)Amend the specifications after their release with appropriate notice to all RFI respondents.
c)Request RFI respondents to present supplemental information clarifying their responses, either in writing or in formal presentation.
3.3OPTIONAL ROUNDTABLE DISCUSSION
To solicit feedback and ask follow-up questions based upon vendor RFI responses, OGS reserves the right at its sole discretion to conduct a structured Roundtable Discussionfor respondents to this RFI only. The Roundtable session will begin with a presentation by key State stakeholders. Following the presentation, State representatives and the vendor community will participatein a structured question and answer session. An agenda,specific questions and other expected topics for discussion will be e-mailed prior to the Roundtable session. At this time, it is not OGS’s intent to have any Respondents give a presentation at the Roundtable session.
Only entities that submit a response to the RFI can attend the Roundtable. Respondents to the RFI interested in attending any potential roundtable should contact the State at ,by August 10, 2012. The Roundtable session date will be determined at a later date and interested respondents will receive date, time and location information via e-mail.
Please include the following information in your Roundtable Discussion interest e-mail:
Firm name
Contact information for up to two participating representatives:
- name
- title
- address
- phone number and
- email address.
4ADMINISTRATIVE INFORMATION
4.1COMPANY DEMOGRAPHICS
Question / Company ResponseCompany (Organization) Name
Division/Location
Headquarter Location
Total Number of Employees
Contact Name
Title
Email Address
Phone Number
Are you a minority owned business? (Y/N)
Are you a woman owned business? (Y/N)
If you answered yes to either question above, are you certified with ESDC as a MWBE? (Y/N)
If you are not an M/WBE, do you offer any programs that facilitate M/WBE participation in the provision of quality improvement solutions that could potentially help New York State achieve statewide M/WBE spend targets?
Are you a qualified Small Business enterprise?
A “New York State Small Business” is defined as a company that is a resident to New York State, independently owned and operated, with 100 or fewer employees, and not dominant in its field.
(Y/N)
APPENDIX A
I.CATEGORY-SPECIFIC QUESTIONS
1.Is your organization:
- a Quality Improvement Organization as defined in 42 USC 1902(d)
- a Quality Improvement Organization-like entity as defined in 42 USC 1902(d)
- other (please provide a description of your organization)
Response:
2.Provide a brief summary of your organization’s experience providing quality improvement and utilization review services for state Medicaid programs. Your response shallidentify:
- the state or states the services were provided for
- the types of services provided
- the duration of the engagement(s)
Response:
3.What obstacles, if any, have yourorganization encounteredwhen expanding or considering toexpandinginto other states to provide these services?
Response:
4.What practices would you recommend New York State consider when procuring quality improvement and utilization review services for Medicaid programs?
Response:
II.PRICING
- Does your organization’s contracts bill by:
- hourly rates or
- deliverable based rates for services?
Response:
- What method, if either, do you prefer and why?
Response:
- Is there an industry standard or trend for pricing models for these services?
Response:
III.M/WBE PARTICIPATION
New York State desires to have M/WBE participation under any future contracts for quality improvement and utilization review services.
Consideringthe New York State Finance Law and Governor Cuomo’s Executive Order #8, which seeks to remove barriers to M/WBE participation in state contracting, what recommendations does your company have for New York State as it relates to MWBE participation under a quality improvement and utilization review contract? Please include any other information your company would like to provide related to M/WBE participation.
Response:
IV.ADDITIONAL INFORMATION
Provide and additional concerns, suggestions and/or comments related to quality improvement and utilization review services for State Medicaid Programs not addressed above. Please do not include sales or marketing information in this section.
Response:
RFI22585.docx