R -- POTENTIAL OUTSOURCING OF THE SPECIFIC ASPECTS OF THE MANAGEMENT OF THE SCHOOL BASED HEALTH SERVICES MEDICAID REIMBURSEMENT PROGRAM

Notice Date

January 24, 2001

Contracting Office

Oakland Schools, Office of Purchasing Management, 2100 Pontiac Lake Road, Waterford, Michigan 48328-2735

ZIP Code

48328-2735

Solicitation Number

2001-1

Response Due

March 14, 2001

Point of Contact

Katrina Brunette, 248.209.2032/Contracting Officer, Michael Rangos, 248.209.2209

E-Mail Address

Click here to contact the contracting officer via (katrina.brunette@oakland.k12.mi.us)

Description

Eight Michigan Intermediate School Districts (Berrien ISD, COOR ISD, Genesee ISD, Ingham ISD, Kent ISD, Macomb ISD, Oakland ISD and Wayne RESA, or collectively known as "ISDs") have entered into an informal collaborative effort to identify firms that are qualified to provide consulting services. Each ISD will function as a completely independent organization throughout the procurement process but will use their informal organization for ease of communication with potential vendors. Contract award will ultimately require action by the respective Boards of Education for the member ISDs. The ISDs are requesting qualifications related to the management of the School Health Services (SBHS) Medicaid Reimbursement Program, or its successor (collectively "the program."). The Program provides reimbursement for traditional Medicaid covered services as well as health related therapeutic interventions provided within the school setting. Direct services are reimbursed through Fee for Service Claims. In addition, a quarterly Administrative Outreach Claim is filed which seeks reimbursement for outreach services provided to potentially eligible students who are "at risk." Each ISD currently employs an outside management consulting firm to process all Fee for Service Claims and prepare the quarterly Administrative Outreach Claims. The ISDs are evaluating alternatives to their current situations including continuing to outsource the preparation of the Fee for Service and/or Administrative Outreach Claims to an outside firm, or performing one or both of these functions internally. If an ISD were to pursue processing Fee for Service Claims internally, it is expected that a new computer software package would be needed for this purpose. Therefore, the ISDs are issuing an Request for Qualification (RFQ) as the first step in an Advisory Multi step Process as noted in the Federal Acquisition Regulations 15.202. The RFQ will result in the identification of firms that meet requirements that are deemed by the ISDs to be essential for entering into a Request for Proposal (RFP) process. Accordingly, the ISD's are seeking proposals for qualifications which will address these alternatives. Firms are invited to submit qualifications to provide any one, or all, or any combinations of the following: (a)Processing of Fee for Service Claims under an outsourcing arrangement; (b)Preparation of quarterly Administrative Outreach Claims under an outsourcing arrangement; (c)Computer software package to enable the ISDs to process Fee for Service Claims internally. Firms that are interested in bidding for these services will be required to demonstrate both qualification and capacity to fulfill contractual obligations. Core firm competency's should include the ability to: (a) design and install quality assurance systems to meet HCFA audit requirements; (b) process records and documentation required for claims using appropriate technologies; (c) develop state Medicaid plans and interact with state and federal agencies; (d) develop, document and provide training to providers and other reimbursable school personnel; (e) monitor all aspects of quality operating systems and claims resolution processes; (f) provide technical support for all aspects of the Medicaid billing program for Fee for Service and/or Administrative Outreach; (g) apply security measure to data system; (h) deliver a smooth transition to the selected firm; and, (h) develop and provide innovative solutions to client issues. When calling, be prepared to state name, address, and solicitation number. All responsible sources may submit qualifications which will be considered.*****

Web Link

NA (NA)

Record

Loren Data Corp. 20010126/RSOL010.HTM (W-024 SN50B774)