RFP #24-16 MMIS Electronic Data Interchange Q&A...RFP #24-16 MMIS Electronic Data Interchange Q&A...

RFP #24-16

MMIS Electronic Data Interchange

Q&A

RFP Section Question Answer

1 Has a budget been identified for this project? May I know an estimated value

for this project, if possible? The Department does not provide this information.


2 Is there an incumbent vendor in contract for this services? If so, may I know

the vendor name and contract expiry date?

No, no incumbent for the EDI RFP services exists.


3 What is the estimated cost of the Electronic Data Interchange (EDI) Services? Refer to the response to Q.1.


4

Has the Department allocated funding for the Electronic Data Interchange (EDI) Services yet? If so, through which source (budget, CIP, state/federal grant, etc.)? If no funding is secured, which sources will be sought and when? If utilizing a grant, would you be able to specify which one?

Refer to the response to Q.1.


5

Does the Department plan to release a single RFP for each of the following modules:

o Managed Care o Financial o Provider Management o Fee For Service o Outpatient Drug Rx o Prior Authorization o PIMS o TPL

Refer to Appendix C – MMIS 2020 Platform Timeline of the RFP, which defines the manner in which the Department anticipates the various RFPs will be released.


6 When the Department states they are looking at options for Electronic Visit

Verification implementation, does the Department already an EVV solution or will they be looking acquiring a EVV module?

The Department will acquire an EVV solution.

RFP #24-16


Q&A


7 If the Department is seeking an EVV module, when would the Department

acquire and through what procurement method? The procurement method and timeline have not been determined.


8

What all are the types of Inbound transactions/EDI messages currently in use by Pennsylvania’s current MMIS?

Refer to general, technical, and functional requirements sections of the RFP for the MMIS 2020 Platform.


9

Are all the validations or both real time and batch processing of messages will be done in EDI systems/Framework or will it be taken care in the ESB Framework?

The EDI module is responsible for creating the validation messages and making them available to the SI/DH for further processing.


10 Which ESB (Enterprise Service Bus) has been shortlisted to connect the EDI

Services/Workflow with the earlier existing PROMISe™ System or in the new MMIS 2020 Platform?

None.


11 What all are the Messaging Standards used in the Current

PROMISe™ System?

Please refer to Section III-1.E.5 and Section I-29 for requirements in this RFP.


12

What are all the Web security standards expected from the implementation of EDI Services implementation?

See question 11.


13

What are all the technology stacks used for legacy applications operating as standalone systems with unique technologies, business rules, and data sets?

The current MMIS system’s functions are different from those that will be required through this RFP. The MMIS 2020 Platform is a separate system and will be developed, designed, and implemented accordingly.

RFP #24-16


Q&A


14

We assume that the environment setup is done at client side? This will need coordination with PA Stakeholders for EDI – MMIS 2020 network team to setup the required network with the vendor location at Onshore. Please confirm?

The EDI module will communicate directly with the SI/DH.


15 Are you planning to share the code repository tool already in use by PA -

MMIS Program? Or will it need to be procured by the offeror?

The selected Offeror will be responsible for procurement of all required tools.


16 What are the vendor responsibilities during post go-live support? What is the

duration of post go-live?

Refer to Section III-8.A.22EDI Maintenance and Operations Plan.


17

Are there any performance expectations for implementation of EDI Services? If yes, what should be the expected volume considerations?

Yes, the selected Offeror will be required to comply with all RFP requirements. In addition, the Department has identified several performance standards that will be specifically measured. Refer to Section III-10 Performance Standards. Refer to Question 146 for volumes.


18

Is there a “Memorandum of Understanding (MOU) in place with external trading partners for data exchange?

Yes.


19

How many trading partners are already exchanging data in EDI format in the current system and what are the number of interfaces (Batch/Web)?

Currently, the Department has 11 VANS, 186 Clearinghouses, 611 Approved software products and 3800 registered providers, groups and MCOs.

RFP #24-16


Q&A


20

How many new trading partners are anticipated to exchange data in EDI format and what will be the number of interfaces (Batch/Web)?

We do not anticipate the addition of new trading partners resulting from the implementation of the MMIS 2020 Platform.


21 What is the number of EDI transactions (Batch/ Real-time) anticipated in the

new system?

The anticipated average annual number of EDI transactions is approximately 700 million.


22 What is the current Identity/Access Management/Single Sign-On system and

will it be replaced in MMIS Platform 2020? Please refer to Section III-1.E.8 of the RFP.


23 Is there a need for external users (Business Partners) to logon to the EDI

system? If yes, is the “External User Provisioning” in scope of this RFP? No, all access to the EDI module will be through the portals on the SI/DH.


24

As per requirement #57, the offeror should provide the development/test environment. Therefore, will PA’s applicable department provide the necessary environments and connectivity to the data-hub and other systems? How will the connectivity with external partners be provided?

Please refer to Section III-8.A.15 Test Plan.


25 Are the rules engine expected to act as an enterprise wide rules engine? Please refer to Section III-3.E.117-118.


26

Regarding Technical Requirement # 148, how many different types of transactions are expected to be manually created?

The different transactions will be developed during JAD sessions.


27

Regarding Technical Requirement # 156, is the applicable PA department looking for Platform-As-Service or Software-As-Service model?

Offerors may propose an EDI solution for a project of the size and scope of the MMIS 2020 Platform, and their rationale for doing so.

RFP #24-16


Q&A


28

For requirement # 157, will the applicable PA. department provide the necessary infrastructure to send e-mails/SMS?

The necessary interface will be provided through the Outbound Mail module via the SI/DH. Please refer to Appendix B MMIS 2020 Platform Service Contractor and Module Description.


29 Regarding, requirement # 162, is this requirement applicable only if the

offeror is hosting the solution? The selected Offeror will host the EDI Module.


30 Does the current system have any capabilities for secure email? Yes.


31

Does DXC have any product/application that handles part of the proposed requirements?

The Department is not aware of what, if anything, DXC will be proposing as the EDI solution. The requirements for the MMIS 2020 Platform are different from those of the current MMIS.


32

Does PA already use any Rule Engine on the current system? The Rule Engine on the MMIS system should be used as repository of rules across the system or utilized for adjudication/validation process for the applications used in MMIS system?

The MMIS 2020 Platform will have a Business Rule Engine (BRE) housed on the SI/DH, which will be used across the system for all MMIS 2020 Platform modules. PROMISe does not have a dedicated BRE.


33

What are the current capabilities of the Provider portal system? For example, can the system accept online claims and referrals/authorizations, upload of EDI files, claim estimates, Provider directory, etc?

The MMIS 2020 Platform is a separate system and will be developed, designed, and implemented in accordance the requirements of MMIS 2020 Platform RFPs. Please refer to

RFP #24-16


Q&A the requirements in Section III-1 Requirements for the MMIS 2020 Platform. The current MMIS system’s functions are not relevant to this RFP.


34 Does the current system has any file management system similar to FileNet? Refer to the response to Q.33.


35 Does the current system have applications that adhere to CAQH guidelines for

EDI transaction? Refer to the response to Q.33.


36

Do the PA have vendors that send files on proprietary formats to submit EDI transactions?

No.


37 What is the current product used for ETL, Reports and EDW? Refer to the response to Q.33.


38 What is the frequency of mock DR activity and the applications that should be

available in DR environment? Please refer to Section III-1.A Disaster Recovery.


39 What are the current legacy applications that the state plans not to replace

but retain and integrate with the new applications that are built for the MMIS system?

Please refer to Appendix B - MMIS 2020 Platform Service Contractor and Module Description.


40 Does PA expect contractor to work with CMS directly and get this certified

(Golden Nugget) for PA State or PA. facilitate this process? Please refer to Section III-8.A.21 EDI CMS Certification.


41

What is the duration involved post go-live of MMIS system? Any financial constraints involved?

Please see Appendix C, MMIS 2020 Platform Timeline, for the anticipated M&O period. We do not understand the question regarding financial constraints.

RFP #24-16


Q&A


42 Should this portal capable of showing real-time EDI transactions/files health E2E including progress? Or to show case static statistics from past data.

Please refer to Section III-1.E.100.


43

Will the VPN (VAN) connectivity with TPs - TP agreements, Infrastructure facilities be provided by PA.?

No, the Department is not supplying any facilities for the EDI Module. For security requirements, please refer to Section III-1.E and Section I-29 Standards.


44

Will PA take care of the dealings with external vendors (like MCOs) who sends Encounters/FFS transactions to PA for the purpose including but not limited to processing/adjudication, auditing, EUM etc.?

If the reference to “dealings with external vendors” means addressing inquires relating to EDI operations, the Offeror is responsible for handling all Tier 2 questions and will assist in developing the knowledge base for answers to Tier I EDI questions. Please refer to Section III-1.F.16 and III-3.H Tier 2 Technical Support


45

How many real time or static EDI reports (Internal/External) are present in PA's inventory? Infrastructure inventory should hold this information across environments like Development, QA and Production, where the EDI data are processed/stored. Can you please confirm and/or expand.

Please refer to Section III-1.D.6-8 and Section III – 9 Reports and Program Controls and


46 Is PA is expecting all EDI transactions/data to be encrypted during inbound/outbound processing or Is there any selected data/elements in EDI to be encrypted at the database level? Example: SSN

Yes, the Department is requiring encryption, please refer to Section III-1 Requirements.


47

Server clusters, load balancers, secure domains/Protocols, DMZ infrastructure facilities will be provided by PA. Is this assumption correct?

No, please refer to Section III-1 Requirements.

RFP #24-16


Q&A


48

Appendix A - DH already contains Jobs scheduler capability as per our understanding. Does this requirement imply to have a separate scheduler for EDI transactions/gateway alone?

Offerors may propose an applicable solution for a project of the size and scope of the MMIS 2020 Platform, and their rationale for doing so.


49

Our understanding is the offeror will propose the best in market automated tools. Will PA bear the licensing costs or should the offeror procure the software licenses/acquisition fees?

The selected Offeror will be responsible for procuring the applicable licenses and the payment of the applicable fees.


50

Should offeror procure hardware/software apart from installation/configuration of Development/QA environments?

Yes, the selected Offeror will be responsible for procuring the necessary hardware and software to implement an EDI solution.


51

What technologies are envisioned for the SI/DH to operate upon in the future MMIS (ESB)?

The SI/DH RFP has not been released. Respondents to the SI/DH RFP will propose technology to be used for the MMIS 2020 Platform.


52 Also, what are the key technologies leveraged in the as-is MMIS? None.


53 How many state/payer specific (customized to PA Medicaid LOB) EDI business rules are entertained in the current As-Is MMIS? And how is it maintained in as-is MMIS?



54

Do you have any security compliant checklist for the website to comply with? Example: SSL Server test, TLS 1.0/2.0 protocol, https layered, wildcard certificates etc. Should they also be configured to run mobile apps as well? Will they be exposed to providers/members only?

Yes, please see Section III-1 Requirements and Section I-29 Standards.

RFP #24-16


Q&A


55 Is the 98% of the 2 seconds response processing time a CAQH CORE requirement for real-time transactions or is it PA specific requirements?

Please refer to Section III-10 Performance Standards. Performance standards are Department specific.


56

How are the paper transactions handled in as-is landscape? Is it being EDI converted and handled thru clearinghouse? What is the process for scanning the applicable documents?



57

What are the current transactions handled in as-is landscape? Our understanding is this includes 837s, 820, 834, 835, 270/271, 276/277. Are there any additional transactions? If so what are they?

Please refer to Section I-4.A General. The selected Offeror must send and accept HIPAA – mandated and other standard healthcare transactions.


58 Are the encounters; outbound/inbound in scope for this RFP? Refer to the response to Q.57.


59 Please confirm no TPL licenses will be incurred by the offeror. Correct?

The Department does not understand what TPL licenses means in reference to the RFP.


60

Please confirm the no payment processing or check generation will be incurred by the offeror.

Confirmed.


61 Are there other transactions besides ASC x 12N and NCPOP? Refer to the response to Q.57.


62

Does BRE apply to EDI module? Please explain. Yes, it will be defined during JAD sessions.

RFP #24-16


Q&A RFP Section Question Answer

63 How does EDI workflow differ from ESB for overall platform? All data for the MMIS 2020 modules

will flow through the SI/DH.


64 What current EDI platform does MMIS use? Are there multiple EDI platforms?



65

Does EDI module need to synchronize with ODS? Please see Section 1-3.D Future State MMIS 2020. The transactional data will be shared across the solution and be synchronized with the ODS. Details will be determined during Joint Application Design.


66 How many different EDI formats does the state plan to support? Refer to the response to Q.57.


67

Is there any restrictions on delivery via cloud SaaS solution vs. on-premise solution?

Offerors may propose a cloud SaaS solution; however, the Department will not host an on-premise solution. Please refer to Section I-29.A Standards.


68 Is there a preference of prime vendor providing technology solution? Can prime vendor contract with a COTS product company?

No. Yes.


69

We are coming up with additional questions based on today’s meeting, can you revise the deadline for question submittal from 4 p.m. today until sometime next week?

The Department extended the deadline; refer to RFP 24-16 Addendum 2 on eMarketplace.

RFP #24-16


Q&A


70 Will the solution be on COPA hosted infrastructure or other off-prem or cloud hosted infrastructure?

The Department or COPA is not hosting; the selected Offeror will host the infrastructure.


71

RFP, I-12.B.3.c, pg. 20 c. Tab and Section headings, shown in RFP Part I, Section I-12B, Proposal Requirements, MUST be used.

Section I-12.B.3.c states: Tab and Section headings, shown in RFP Part I, Section I-12B, Proposal Requirements, MUST be used. The numbered Tab headings in Section I-12B do not correspond to the numbered headings in Part III - Technical Submittal. Tabs: 2. Requirements 3. Statement of the Problem 4. Management Summary While Section III Section Headings: 1. Requirements 2. Statement of the Problem 3. Management Summary Please confirm that proposal heading and subheadings should correspond to the tab numberings outlined in Part 1, Section I-12B as follows: 2. Requirements 2.A Disaster Recovery 2.B Emergency Preparedness Etc.

Proposal Headings and subheadings should align with Part III; the Tabs within the Technical Submittal should align with Section I-12 Proposal Requirements.


72

RFP, I-12.B.3.f, pg. 20 f. Exceptions for paper and font size are permissible for project schedule (Microsoft Project) or for

Section I-12.B.3.f states: Exceptions for paper and font size are permissible for project schedule (Microsoft Project). However, Section III-8, Work Plan states “Describe in narrative form your technical plan for accomplishing the work.” There does not appear to be a requirement for Offerors to submit a project schedule in MS Project with their proposal.

A Project Schedule in Microsoft Project is not required but a work plan is required.

RFP #24-16


Q&A graphical exhibits and material in appendices which may be printed on white paper with dimensions of eleven (11) by seventeen (17) inches.

Please clarify whether a project schedule developed in Microsoft Project is required and if so, where in the proposal Offerors should include it.


73

RFP, III-1.B.2 pg, 72 & 89 III-6: The Offeror must submit a draft copy of its proposed training plan(s), to include, at a minimum, all training methods, facilities, materials, and its approach to the MMIS 2020 Platform training. … RFP, III-6; III-8.A.25 III-D.9.B III-8.A.25: Offerors must submit a draft outgoing turnover plan with its Technical Submittal. … III-D.9.B: The Offeror must provide a sample monthly status report with its Technical Submittal.

The RFP appears to require Offerors submit three draft or sample artifacts/plans with their proposal: Draft Training Plan (III-6), Draft Outgoing Turnover Plan (III-8.A.25), and a Sample Monthly Status Report (III-9.D). The RFP also gives Offerors the option to include a Continuity of Operations Plan (“COOP”) (III-1.B.2) All other requirements that reference artifacts appear to require Offerors provide a narrative description of the plan or the approach to developing a referenced plan, rather than the plan itself. For example: III-8: Work Plan. Describe in narrative form your technical plan for accomplishing the work. III-8.A Program Management. The Offeror must describe its approach to designing, developing, implementing, and maintaining the EDI-MWP with recommended timelines for completion of the components. III-8.A.1 EDI Charter. The Offeror must describe its approach to the design, development, implementation, and maintenance of the EDI Charter Please confirm our interpretation that the Draft Training Plan, Draft Outgoing Turnover Plan, and Sample Monthly Sample Reports are the required artifacts for inclusion in the proposal.

Yes, they are the required artifacts for the technical submittal.

RFP #24-16


Q&A


74

RFP, III-8.A Program Management, pg. 73 The selected Offeror must develop the EDI MWP that, at a minimum, includes the following deliverables:

Please confirm that the 27 deliverables listed on page 73 are required of the selected Offeror during the course of the contract and not, unless otherwise indicated, required in the proposal.

Yes.


75

RFP, I-12.A Proposal Submission III-4.B, References III-5.D (Offeror Personnel) References, pg. 71 A. Proposal Submission. To be considered, Offerors must submit a complete response to this RFP to the Issuing Office, using the format provided in Part I, Section I-12B, providing six (6) paper copies [one marked "ORIGINAL"] of the Technical Submittal and one (1) paper copy of the Cost Submittal and two (2) paper copies of the Small Diverse Business and Small Business ("SDB/SB") Participation Submittal

RFP Section I-12.A requires offers to submit two "complete and exact" copies of the entire proposal on CD-ROM or flash drive, which "must be a mirror image of the paper copy". Sections III-4.B and III-5.D require Offerors to provide completed Appendices G and H in sealed envelopes and include them, still sealed, with the proposal. We presume this requirement is intended to prevent Offerors from reviewing or altering forms prior to submittal.

a. In this case, how does DHS recommend we account for these completed appendices on proposal copies submitted on electronic format?

May Offerors include completed versions of Appendices G and H in electronic format, which would result in Offerors seeing these completed appendices prior to submission?

References do not need to be provided on the CD-ROM or flash drive. No.

RFP #24-16


Q&A and related Letter(s) of Intent. In addition to the paper copies of the proposal, Offerors must submit two (2) complete and exact copy of the entire proposal (Technical, Cost and SDB/SB submittals, along with all requested documents) on CD-ROM or Flash drive in Microsoft Office or Microsoft Office-compatible format. The electronic copy must be a mirror image of the paper copy and any spreadsheets must be in Microsoft Excel. Additionally, on the CD-ROM or Flash drive, include separate folders that contain a complete and exact copy of the entire Technical (excluding financial capability) Submittal in a searchable PDF (portable document format). … The Offeror must submit Appendix G, Corporate Reference Questionnaire, directly to the contacts

RFP #24-16


Q&A listed. The references should return the completed questionnaires in sealed envelopes to the Offeror. The Offeror must include these sealed references with its technical submittal under Tab 14. … The Offeror must submit Appendix H, Personnel Reference Questionnaire, directly to the contacts listed. The references should return completed questionnaires in sealed envelopes to the Offeror. The Offeror must include these sealed references with its Technical Submittal under Tab 15.

RFP #24-16


Q&A


76

RFP, I-12.A Proposal Submission III-4.B, References III-5.D (Offeror Personnel) References, pg.71 A. Proposal Submission. To be considered, Offerors must submit a complete response to this RFP to the Issuing Office, using the format provided in Part I, Section I-12B, providing six (6) paper copies [one marked "ORIGINAL"] of the Technical Submittal and one (1) paper copy of the Cost Submittal and two (2) paper copies of the Small Diverse Business and Small Business ("SDB/SB") Participation Submittal and related Letter(s) of Intent. … The Offeror must submit Appendix G, Corporate Reference Questionnaire, directly to the contacts

Please clarify whether the Offeror must include sealed references (Appendices G and H) only in the copy marked “ORIGINAL” or in all six copies of the Technical Submittal. If sealed references are only required in the copy marked “ORIGINAL,” please clarify how Offerors should include these appendices in the other hard copies.

The sealed references should be provided with the Original Technical Submittal; additional copies are not required.

RFP #24-16


Q&A listed. The references should return the completed questionnaires in sealed envelopes to the Offeror. The Offeror must include these sealed references with its technical submittal under Tab 14. … The Offeror must submit Appendix H, Personnel Reference Questionnaire, directly to the contacts listed. The references should return completed questionnaires in sealed envelopes to the Offeror. The Offeror must include these sealed references with its Technical Submittal under Tab 15.


77

RFP, III-5.D (Offeror Personnel) References, pg. 71 All client references for Key Personnel must be outside clients (non-DHS) who can provide

May key personnel references include former DHS employees? Yes, former employees may be used as references.

RFP #24-16


Q&A information on the individual’s experience and competence to perform project tasks similar to those requested in this RFP.


78 RFP, Evaluation Criteria

There are a total of 500 points available to the technical evaluation and 253 required responses. Will the Commonwealth provide more information on the evaluation weighting by proposal section?

Please see Section II-4 Evaluation Criteria for the weight assigned to the major evaluation criteria.


79 Appendix M Cost Submittal worksheet

The formula in year 2 does not factor in the 4 months of M&O in year 2. Please validate or clarify if this formula is correct or if the intention is for 20 months of DDI/Implementation with a 4 month gap before M&O begins.

A revised Appendix M – Cost Submittal Worksheet is provided with this Addendum to the RFP.


80

RFP, III-1 E.1 Technical Requirements, pg. 35-36 The corresponding CMS MECT 2.2 Checklist requirement numbers are TA.SP.13, TA.SP.15, TA.SP.18, TA.SP.28, TA.SP.3, TA.SP.37, TA.SP.37, TA.SP.38, TA.SP.42, TA.SP.53, TA.SP.57, TA.SP.58, TA.SP.74, TA.SP.75, TA.SP.76 and TA.SP.77.

Technical Requirement #1 includes a list of corresponding CMS MECT 2.2 Checklist requirements that includes the following: “TA.SP.3, TA.SP.37, TA.SP.37,” TA.SP.37 is repeated. Please confirm the correct MECT requirement numbers.

The first reference should be TA.SP.27.

RFP #24-16


Q&A


81

RFP, III-1 E. 25 Technical Requirements, pg. 40 The selected Offeror must capture root information on all changes to critical records and data fields (e.g., SSN, Name) that occur and publish this information to the ODS, including identification of the responsible system user and date and time of the change. The corresponding CMS MECT 2.2 Checklist requirement numbers are TA.SP.37, TA.SP.37 and TA.SP.39.

Technical Requirement #25 includes a list of corresponding CMS MECT 2.2 Checklist requirements that includes the following: “TA.SP.37, TA.SP.37,” TA.SP.37 is repeated. Please confirm the correct MECT requirement numbers.

The first reference should be TA.SP.27.


82

RFP, Part III-8 Work Plan, pg. 73 The listing of the deliverables on page 73 is numbered differently from the numbering of the deliverables on pages 74-90. For example, on page 73, the EDW/MWP lists: 12. HIPAA Companion Guide for trading partners and the Department.

Would the Commonwealth please number the deliverables on page 73 and pages 74-90 the same?

The list of deliverables in the RFP, Part III-8 Work Plan, pg. 73 has been changed to the following: 1. EDI Charter 2. EDI Master Schedule 3. EDI Communications Plan 4. Risk Management Plan 5. Requirements Management Plan 6. Defect Management Strategy 7. Change Management Plan 8. EDI Release Management Plan 9. Configuration Management Plan 10. System Security Plan

RFP #24-16


Q&A However, on page 81, #12 is 12. Quality Management Plan.

11. HIPAA Security Plan 12. Quality Management Plan 13. EDI Documentation Management Plan 14. Training Plan 15. Test Plan 16. EDI Rollback Plan 17. EDI Implementation Plan 18. DR Plan 19. COOP 20. EDI CMS Certification Plan 21. EDI Closeout Plan 22. EDI Maintenance and Operations Plan 23. Technical Infrastructure Document 24. System Design Document 25. Turnover Plan


83

RFP, Part III-8 Work Plan, pg. 73 12. HIPAA Companion Guide for trading partners and the Department is included in the list of deliverables on page 73 but is not included in the descriptions of the deliverables on page 74-90. One would expect to find the detailed description on page 81 preceding the Quality Management Plan, but it appears to be missing.

12. HIPAA Companion Guide for trading partners and the Department is included in the list of deliverables on page 73 but is not included in the descriptions of the deliverables on page 74-90. Please confirm if a detailed description of the HIPAA Companion Guide should be included on page 81 following “11. HIPAA Security Plan.”

See Question 82. The HIPAA Companion Guide has been removed.

RFP #24-16



84

RFP, Part III-8 Work Plan, pg. 73 & 65 The RFP lists the Tier 2 Support Center as one of the EDI MWP deliverables, but does not include this deliverable in pages 74-90. However, the RFP describes Tier 2 Technical support in Section H. on page 65.

The RFP lists the Tier 2 Support Center as one of the EDI MWP deliverables, but does not include this deliverable in pages 74-90. However, the RFP describes Tier 2 Technical support in Section H. on page 65. Please address this discrepancy.

See Question 82, the Tier 2 Support Center has been removed.


85

RFP, I-12.A Proposal Requirements, pg. 19 In addition to the paper copies of the proposal, Offerors must submit two (2) complete and exact copy of the entire proposal (Technical, Cost and SDB/SB submittals, along with all requested documents) on CD-ROM or Flash drive in Microsoft Office or Microsoft Office-compatible format.

Section I-12.A says Offerors must submit two copies on CD-ROM or Flash drive in Microsoft Office or Microsoft Office-Compatible format. Please confirm the Commonwealth considers Adobe PDF format qualifies as “Microsoft Office-Compatible” and would be acceptable for the electronic submission described.

Confirmed. Adobe PDF format is considered Microsoft Office-Compatible.


86

RFP, I-12.B.3, pg. 20 Proposals must adhere to the following format…

RFP Section I-12.B.3 requires size 12 font and allows exceptions for project schedule (Microsoft Project), graphical exhibits, and material in appendices. Would the Commonwealth also allow exceptions for page headers and footers and allow larger font size for section headings?

Yes, as long as they are readable.

RFP #24-16


Q&A b. Must use Arial or Times New Roman font with a size of twelve (12). f. Exceptions for paper and font size are permissible for project schedule (Microsoft Project) or for graphical exhibits and material in appendices which may be printed on white paper with dimensions of eleven (11) by seventeen (17) inches.


87

RFP, III-1. F, # 17, pg. 62 The Department receives and transmits multiple files on a daily basis from many Authorized Trading Partners twenty four hours a day, seven days a week, three hundred sixty five days a year. The selected Offeror must support this function. Explain your solution for capturing multiple files from DHS’s Authorized Trading Partners. Explain the maximum number of users, files size and transmissions that can be accepted simultaneously. Explain how your solution

Functional Requirement 17 states: “The Department receives and transmits multiple files on a daily basis from many Authorized Trading Partners twenty four hours a day, seven days a week, three hundred sixty five days a year. The selected Offeror must support this function” Does the Department expect the EDI module to accept flat files from different trading partners and translate to the appropriate HIPAA transaction set?

Presently, no, however; the Offeror may propose a solution for the Department’s consideration.

RFP #24-16


Q&A is scalable to accommodate future Authorized Trading Partners. Describe your ability to identify high-volume EDI submitters and restrict or throttle their EDI submissions, at the direction of the Department. The corresponding CMS MECT 2.2 Checklist requirement number is IA.LDM.1.


88

RFP, III-1. E # 80, pg. 47 85. The selected Offeror must provide the ability to function on a real-time basis. No EDI-specific MECT 2.2 checklist requirement has been identified. 100. The selected Offeror must send and accept batch and real-time representation of applicable HIPAA mandated and other standard health care transactions. The information exchanged will support a variety of

In Technical Requirements # 85 and 100, the RFP states: 85. The selected Offeror must provide the ability to function on a real-time basis. No EDI-specific MECT 2.2 checklist requirement has been identified. 100. The selected Offeror must send and accept batch and real-time representation of applicable HIPAA mandated and other standard health care transactions. The information exchanged will support a variety of formats, including X12, NCPDP, XML, and JSON formats. The corresponding CMS MECT 2.2 Checklist requirement numbers are IA.DS.11, IA.DS.5, TA.SP.16 and TA.SP.17. Which EDI transactions are expected to function on a real-time basis?

At a minimum, transactions 270/271 and 276/277. Additional transactions may be determined during Joint Application Design sessions.

RFP #24-16


Q&A formats, including X12, NCPDP, XML, and JSON formats. The corresponding CMS MECT 2.2 Checklist requirement numbers are IA.DS.11, IA.DS.5, TA.SP.16 and TA.SP.17.


89

RFP, III-1. E # 94, pg. 48 94. The selected Offeror’s solution must preserve committed transactions in a manner that so that no greater than one (1) minute of committed transaction data is lost as the result of an unplanned outage. No EDI-specific MECT 2.2 checklist requirement has been identified.

Requirement #94 - What is considered committed transaction data? Is it when the transaction has received a unique identification number?

Correct.


90

RFP, III-1. E #148, pg. 56 148. The selected Offeror must provide screens for data entry with identified mandatory and optional data fields, including basic validations on data entry (e.g. recognizing invalid characters or an incorrect

Technical requirement #148 States: “The selected Offeror must provide screens for data entry with identified mandatory and optional data fields, including basic validations on data entry (e.g. recognizing invalid characters or an incorrect number of characters).” An EDI solution as required by this RFP generally facilitates system to system transactions in standard format that are routed and mapped outside of utilization of a user interface. A transactional user interface is usually held within the business application, such as claims through a claims portal, in another part of the MMIS. These could then be routed through EDI. Please

No, the data from that transaction would be used, but the actual screen would reside on the Provider Portal on SI/DH.

RFP #24-16


Q&A number of characters). The corresponding CMS MECT 2.2 Checklist requirement numbers are TA.FR.1, TA.SP.1 and TA.SP.2.

confirm the EDI system will not be forward facing for individual manual transaction entry. If the EDI system is to have a user interface, please describe in detail what specific things are required and how this differs from those other possible transactional interfaces.


91

RFP, III-1. E #163, pg. 58 163. The selected Offeror must provide for the easy search and retrieval of historical data for all types of data. Data retrieved must include only the targeted files and documents. No EDI-specific MECT 2.2 checklist requirement has been identified.

Requirement #163 says “selected Offeror must provide for the easy search and retrieval of historical data for all types of data.”

a) Is this referring to functionality for the provider to pull back historical data that relates to them or for DHS to retrieve historical data across all systems/subsystems or both?

b) What data is expected to be searched and retrieved? Please specify the retention timeframe for each type of data.

a) Yes, a minimum of 180 Days. Please refer to EDI-15 Auditing /Archiving performance standard in the RFP. b) All transactions received through the EDI Module.


92 RFP 24-16 Labels

The RFP Attachment “RFP 24-16 Labels.pdf” includes labels for a “Potential Optional Future Services Submittal”. Is a Potential Optional Future Services Submittal required or available in this procurement?

The correct RFP 24-16 Labels document was posted; it does not contain a label for a Potential Optional Future Services Submittal.


93

RFP, III-4.A, pg. 66 The Offeror must describe its corporate identity, legal status and forms, including the name, address, telephone number, and email address for the legal

In Section III-4.A, the RFP states: “The Offeror must describe its corporate identity, legal status and forms, including the name, address, telephone number, and email address for the legal entity that is submitting the proposal.” Clarify what is meant by “forms” in the context of this requirement.

The Department meant “form” rather than forms.

RFP #24-16


Q&A entity that is submitting the proposal.


94

RFP, III-1.E Technical Requirements #115, pg. 52 115. The workflow will be used for applications implemented by the proposed solution and the selected Offeror must make it available for external use by other MMIS 2020 Platform module contractors, as required.

Please provide further definition for “The workflow”. The Department is removing this requirement.


95

RFP, III-1.F. Functional Requirements #34, pg. 64 34. The Department has several VANs as Authorized Trading Partners. The selected Offeror’s solution must support the Department’s current VAN Authorized Trading Partners. Describe in detail your process for migrating the Department’s current VAN Authorized Trading

Functional requirement #34. In our experience, the onboarding and revalidation of existing trading partners on the new system is an extremely lengthy task of the implementation. Has the Commonwealth determined the percentage of trading partners that must be recertified prior to go live and what incentives to use in order to have the trading partners recertify?

The Department anticipates that all trading partners will be recertified prior to implementation. The Department does not plan to offer incentives.

RFP #24-16


Q&A Partners to your solution. Explain the timeline from migration initiation to completion of integration into your solution.


96

RFP, I-18.A and III-4, pg. 21 & 66 I-18. Proposal Contents. A. Confidential Information. The Commonwealth is not requesting, and does not require, confidential proprietary information or trade secrets to be included as part of Offerors’ submissions in order to evaluate proposals submitted in response to this RFP. Accordingly, except as provided herein, Offerors should not label proposal submissions as confidential or proprietary or trade secret protected. Any Offeror who determines that it must divulge such information as part of its proposal must submit the signed written statement described in Subsection C

In Section I-18.A, the RFP states “The Commonwealth is not requesting, and does not require, confidential proprietary information or trade secrets to be included as part of Offerors’ submissions in order to evaluate proposals submitted in response to this RFP. Accordingly, except as provided herein, Offerors should not label proposal submissions as confidential or proprietary or trade secret protected.” Section III-4 requires Offerors to include for referenced projects “name, address, and telephone number of the responsible official of the customer, company, or agency who may be contacted.” Offerors typically consider this information confidential. Please confirm information should be included in Offerors’ proposal and that is acceptable to redact.

Confirmed, the information should be included and may be redacted. Please see Section I-18.A. and C., which provide that an Offeror may designate proposal information confidential and the manner in which such a designation should be made.

RFP #24-16


Q&A below and must additionally provide a redacted version of its proposal in accordance with RFP Part I, Section I-12, which removes only the confidential proprietary information and trade secrets, for required public disclosure purposes.


97

RFP, III-F.7, pg. 60 The selected Offeror’s solution must receive, process, and return the HIPAA-mandated attributes that are utilized to enforce the Department’s policy. The Department requires transactions to be configurable based on procedural needs. Please explain how your solution will accommodate the Department’s needs. No EDI-specific MECT 2.2 checklist requirement has been identified.

In III-F.7, the RFP says: “The Department requires transactions to be configurable based on procedural needs.” In the context of EDI transactions which follow a stringent structure, can the Department clarify what is meant by “configurable based on procedural needs”?

This will be determined during Joint Application Design sessions.

RFP #24-16


Q&A


98

Appendix E - Proposal Cover Sheet, pg. 19 An official authorized to bind the Offeror to its provisions must sign the proposal. If the official signs the Proposal Cover Sheet (Appendix E to this RFP) and the Proposal Cover Sheet is attached to the Offeror’s proposal, the requirement will be met.

Please clarify in which submittal (Technical, Cost or SDB/SB) Offerors should include Appendix E, Proposal Cover Sheet.

The Offeror should include Appendix E - Proposal Cover Sheet with the Technical Submittal.


99

Appendix L - Trade Secret Confidential Proprietary Information Notice, pg. 21 Refer to Appendix L of the RFP for a Trade Secret Confidential Proprietary Information Notice Form that may be utilized as the signed written statement, if applicable.

Please clarify in which submittal (Technical, Cost or SDB/SB) Offerors should include Appendix L, Trade Secret Confidential Proprietary.

The Technical Submittal should include Appendix L – Trade Secret Confidential Proprietary Information Notice.


100 Appendix M - Cost Submittal Worksheet

The cost worksheet is protected and we are unable to adjust the width of the columns. Please widen columns F:H in order for Offerors to see the total cost.

A revised Appendix M – Cost Submittal Worksheet is provided with this Addendum to the RFP.

RFP #24-16



101

RFP, III-1. Requirements, E. Technical Requirements, #100, pg. 49 100. The selected Offeror must send and accept batch and real-time representation of applicable HIPAA mandated and other standard health care transactions. The information exchanged will support a variety of formats, including X12, NCPDP, XML, and JSON formats. The corresponding CMS MECT 2.2 Checklist requirement numbers are IA.DS.11, IA.DS.5, TA.SP.16 and TA.SP.17.

Could the Commonwealth specify the healthcare transactions that will be exchanged in JSON and XML formats using the proposer's EDI solution?

This requirement will be determined during Joint Application Design sessions in collaboration with the SI/DH contractor.


102

RFP, III-10. Performance Standards, EDI-3 System Availability, pg. 94 All test and training environments will be available 6am - 6pm Monday through Friday and as agreed to during testing and training windows.

Please clarify that available hours are for Eastern Standard Time (EST) zone. Is this applicable to state holidays?

Available hours are Eastern Standard Time. State Holidays are not excluded for testing and training environments.

RFP #24-16



103

RFP, III-1. Requirements, G. Cyber Security and Risk Mitigation Plan, pg. 64-65 The selected Offeror must take measures to keep Pennsylvania’s Medicaid data secure from cyber data breaches. The Offeror must provide detailed information regarding its cyber security strategy. 1. Describe the security measures that are built into proposed solutions to prevent system and data breaches. 2. Describe preventative measures (e.g., policies, procedures) taken to reduce the risk of cyber-attacks. 3. Provide details of how your solution’s cyber security and risk mitigation plan prevents cyber data breaches, monitors and identifies cyber data breaches, and rectifies cyber data breaches that occur. 4. Describe the frequency of reviews and updates of

The Commonwealth specifies 27 document deliverables on p. 73 to include both a system security plan and a HIPAA security plan. Is the Commonwealth using the term "Cyber Security and Risk Mitigation Plan" synonymously with one of these documents?

No. Refer to the response to Q.82.

RFP #24-16


Q&A the cyber security and risk mitigation plan and the testing process and testing frequency. Deliverable: Cyber Security and Risk Mitigation Plan


104

RFP, I-29. Standards, A. Commonwealth Information Technology Policies. Pg. 25 All proposals must be submitted on the basis that all ITPs and DHS Business and Technical Standards are applicable to this procurement. It is the responsibility of the Offeror to read and be familiar with the ITPs and DHS Business and Technical Standard. Notwithstanding the foregoing, if the Offeror believes that any ITP or DHS Business and Technical Standard is not applicable to this procurement, it must list all such ITPs and DHS Business and Technical Standard in its technical

In order to better assess ITPs and DHS Business and Technical Standards, can the Commonwealth please specify any of the Commonwealth security policies or controls supersede NIST 800-53 or CMS MARS-E?

None of the Commonwealth security policies or controls supersede NIST 800-53 or CMS MARS-E, they are in line and following those Standards/Requirements. Department of Human Services security infrastructure adheres to and complies with MARS-E Requirements for all systems integrated with CMS.

RFP #24-16


Q&A response, and explain why it believes the ITP or the DHS Business and Technical Standard is not applicable. DHS may, in its sole discretion, accept or reject any request that an ITP not be considered to be applicable to the procurement. The Offeror’s failure to list an ITP or DHS Business and Technical Standard will result in its waiving its right to do so later, unless DHS, in its sole discretion, determines that it would be in the best interest of the Commonwealth to waive the pertinent ITP or DHS Business and Technical Standard.


105

RFP, I-29. Standards, B. Federal Standards, #10, pg. 26 10. IRS Publication 1075 – Tax Information Security Guidelines for Federal, State and Local Agencies to include any Service Level Agreement requirements

Will the EDI module be transmitting/receiving Federal Tax Information (FTI)?

The Federal tax identification number could be received on X12 transactions or other HIPAA compliant transactions.

RFP #24-16



106

RFP, II-4. Evaluation Criteria, 28 C. SDB/SB Participation. BDISBO has established the evaluation weight for the SDB and SB Participation criterion for this RFP as 20% of the total points. 1. The SDB and SB point allocation is based entirely on the percentage of the contract cost committed to SDBs and SBs. If the Offeror is a SDB, 100% of the contract cost is allocated to SDB participation. If the Offeror is a SB, 100% of the contract cost is allocated to SB participation. 2. A total combined SDB/SB commitment of less than one percent (1%) of the total contract cost is considered de minimis and will receive no SDB or SB points. 3. Based on a maximum total of two hundred (200) available points for the SDB and SB Participation

Please provide examples of how the evaluation criteria will be applied across technical, cost, and SDB/SB submittals. Specifically, please provide one example of scoring where a proposal is submitted with an SDB/SB entity as the prime contractor and one example of scoring where a proposal is submitted with an SDB/SB entity is a subcontractor to a prime contractor.

Please see Addendum 2, Pre-Proposal Conference, Slides 25-26.

RFP #24-16


Q&A Submittal, the scoring mechanism is as follows: Small Diverse Business and Small Business Raw Score = 200 (SDB% + (1/3*SB %)) 4. The SDB and SB Raw Score is capped at 200. 5. The Offeror with the highest raw score will receive 200 points. Each Offeror’s raw score will be pro-rated against the Highest Offeror’s raw score by applying the formula set forth on the following webpage: http://www.dgs.pa.gov/Businesses/Materials%20and%20Services%20Procurement/Procurement-Resources/Pages/RFP_SCORING_FORMULA.aspx. 6. The Offeror’s prior performance in meeting its contractual obligations to SDBs and SBs will be considered by BDISBO during the scoring process. To the extent the Offeror has failed to meet prior contractual commitments, BDISBO may recommend to the Department that the Offeror be determined

RFP #24-16


Q&A non-responsible for the limited purpose of eligibility to receive SDB/SB points.


107

RFP, III-5 Offer Personnel, D. References, pg. 71 D. References. A minimum of three (3) client references for Key Personnel must be identified. All client references for Key Personnel must be outside clients (non-DHS) who can provide information on the individual’s experience and competence to perform project tasks similar to those requested in this RFP.

Please clarify that the Commonwealth expects to receive three client references for each key personnel, for a total of 15 client references for the key personnel. Note that submitting questionnaires to clients and receiving written feedback in time for submittal is challenging given the proposal submittal deadline. We respectfully request the Commonwealth consider extending the proposal submittal deadline to allow Offerors the time to complete this process.

Confirmed – three (3) references are required for each key personnel. Refer to the proposal submittal deadline provided with this Addendum 4 of the RFP.


108

RFP, III-4. Prior Experience, B. References, pg. 67 B. References. The Offeror must provide a list of at least three (3) relevant contacts within the past four (4) years to serve as corporate references.

Please explain the impact to scoring, if any, if an Offeror includes more than the minimum three corporate references.

The Department does not provide this type of scoring information.

RFP #24-16



109

RFP, III-1. Requirements, F. Functional Requirements, #73, pg. 46 73. The selected Offeror must load, modify, and add manual reference data sets within one (1) business day of approval in real-time. No EDI-specific MECT 2.2 checklist requirement has been identified.

Can the Commonwealth please provide examples of manual reference data sets applicable for the EDI module? What would the reference data sets include? What type of formats would the data sets be provided in?

If applicable to EDI, this will be determined during Joint Application Design sessions in collaboration with the SI/DH contractor.


110

RFP, I-4. Objectives, B. Specific, pg. 17 The Department envisions for inbound transactions, Authorized Trading Partners will submit their standard HIPAA transactions to an EDI Dashboard that resides within the SI/DH.

Does the Commonwealth intend for the EDI Dashboard to be part of the Common Portal? Can the EDI Dashboard reside outside of the SI/DH, as long as it is accessible by authorized users?

The EDI Dashboard will be on the SI/DH and will be accessible by authorized users through the appropriate portal.


111

RFP, III-1. Requirements, F. Functional Requirements, #77, pg. 46 77. The selected Offeror must reconcile all data elements found in the

Is it the expectation that the EDI module reconcile all data elements within the ODS, or only those elements that have been created / updated by the EDI transactions?

Data elements that have been sent via the SI/DH to ODS by the EDI Module will require reconciliation.

RFP #24-16


Q&A ODS. No EDI-specific MECT 2.2 checklist requirement has been identified.


112

RFP, III-1. Requirements, F. Functional Requirements, #113e, pg. 51 113e.Maintaining operating system to latest Department-approved version;

It is the responsibility of the vendor of COTS SaaS solutions to update the underlying infrastructure at periodic intervals to support all of the clients. Is the Department asking for a separate release schedule than the normal update frequency?

Yes. The release schedule must be coordinated with the ITC/QA Contractor, the SI/DH Contractor, and the MMIS 2020 Module Contractors. Please refer to Section III-8.A.8 EDI Release Management Plan.


113

RFP, III-1. Requirements, F. Functional Requirements, #135, pg. 54 135.The selected Offeror’s module windows and screens must be intuitive, easy to use, based on workflows, maintain the appropriate and relevant context, and offer multi-channel assistance.

Can the Commonwealth clarify the expectation for "multi-channel assistance" within the context of Tier 2 support?

The selected Offeror’s Tier 2 responses will be “multi-channel assistance” and include CRM, text, email, and phone.


114

RFP, III-1. Requirements, F. Functional Requirements, #1, pg. 59 1. The Offeror’s solution must support transactions

Can the Department provide a list of the types of transactions they envision beyond the ASC X12N and NCPDP?

Additional formats will be determined during JAD sessions.

RFP #24-16


Q&A other than the current ASC X12N and NCPDP HIPAA transactions.


115

RFP, III-1. Requirements, F. Functional Requirements, #10, pg. 61 10. The selected Offeror’s solution must survey Authorized Trading Partners to ascertain customer satisfaction. Describe how your solution monitors Authorized Trading Partner and the Department’s satisfaction with your solution. Describe the tools and the processes your solution utilizes for monitoring and measuring service quality. No EDI-specific MECT 2.2 checklist requirement has been identified.

How is this satisfaction survey being conducted currently? Does the Department use an existing tool? Can the Department provide an example of the survey and any tools currently being used?

The Offeror should determine the appropriate survey to use based upon its experience working with a solution the size and scope of the MMIS 2020 Platform.


116

RFP, I-12. Proposal Requirements, B. Proposal Format, pg. 20 Must use Arial or Times New Roman font with a size of twelve (12).

Will the Commonwealth permit table text and graphics to have a minimum size of nine (9) point font?

Yes, but the font must be readable.

RFP #24-16



117

RFP, VI-36. Ownership Rights, (u) Commercial Software, pg. 130 If a product or deliverable under this Contract is commercially available software or requires commercially available software for use and the Contractor is not the licensor of the software, the Contractor hereby agrees that, before it incorporates such software into a deliverable, Contractor will inform the licensor of the software that it will be required to enter into a software license agreement with the Commonwealth that incorporates Exhibit C (Software License Requirements) as a material part of the licensor’s software license agreement.

The Software License Requirements at Exhibit C require that the Licensor may not terminate the license for non-payment. The license requirements also require the Licensor to certify that it has undertaken due diligence to ensure that licensed products do not infringe on third party proprietary interests. The Software Licensing Requirements also provide that the licensor’s indemnity of the Commonwealth for patent, copyright, trade secret, or trademark protection is uncapped. These terms are not typical of commercial end user license agreements and may not be agreed to by many COTS vendors. In order for the Commonwealth to benefit from the technical capabilities of such COTS products and not impose a mandatory RFP requirement in the Contract that cannot be met, would the Department consider amending and/or clarifying the RFP to state that for third party COTS products, the Department will review and accept third party COTS licensing terms to the extent those terms are not preempted by Commonwealth law?

Refer to RFP Part III, Section III-11 Objections and Additions to Standard Contract Terms and Conditions. Offerors may identify terms and conditions in RFP Part VI that it would like to negotiate; however, it must submit a proposal based on the terms and conditions in Part VI IT Contract Terms and Conditions and should not assume that the Department will accept its proposed changes.

RFP #24-16


Q&A


118

RFP, VI-31. Commonwealth Hold Harmless, pg. 121 (a) The Contractor shall hold the Commonwealth harmless from and indemnify the Commonwealth against any and all third party claims, demands and actions based upon or arising out of any activities performed by the Contractor and its employees and agents under this Contract, provided the Commonwealth gives Contractor prompt notice of any such claim of which it learns. Pursuant to the Commonwealth Attorneys Act (71 P.S. § 732-101, et seq.), the Office of Attorney General (OAG) has the sole authority to represent the Commonwealth in actions brought against the Commonwealth. The OAG may, however, in its sole discretion and under such terms as it deems

Would the Department consider narrowing the scope of the indemnification obligation of third party claims, demands and actions based upon or arising out of any activities performed by the Contractor’s (including its employees and agents) breach of Contractor’s obligations under the Agreement?

Refer to RFP Part III, Section III-11 Objections and Additions to Standard Contract Terms and Conditions. Offerors may identify terms and conditions in RFP Part VI that it would like to negotiate; however, it must submit a proposal based on the terms and conditions in Part VI IT Contract Terms and Conditions and should not assume that the Department will accept its proposed changes.

RFP #24-16


Q&A appropriate, delegate its right of defense. If OAG delegates the defense to the Contractor, the Commonwealth will cooperate with all reasonable requests of Contractor made in the defense of such suits.


119 General

Can the Commonwealth please specify what the current EDI clearing house solution is and the scope of the EDI transactions provided by this solution?

Currently, our Fiscal Agent uses Business Exchange Services (BES) for all HIPAA compliant transactions. Please refer to Section I-3 Overview of Project and Section I-4 Objectives. The selected offeror must send and accept HIPAA – mandated and other standard healthcare transactions.


120

RFP, III-1. Requirements, F. Functional Requirements, #35, pg. 64 35. The Department has several MCOs as Authorized Trading Partners. The selected Offeror’s solution must support the Department’s MCO Authorized Trading Partners. Describe in detail your process for migrating the Department’s current

Please provide examples/types of transactions that MCOs and their authorized trading partners are going to be submitting.

Please refer to Section I-4.A General. The selected offeror must send and accept HIPAA – mandated and other standard healthcare transactions.

RFP #24-16


Q&A MCOs Authorized Trading Partners to your solution. Explain the timeline from migration initiation to completion of integration into your solution. No EDI-specific MECT 2.2 checklist requirement has been identified.


121

RFP, III-1. Requirements, F. Functional Requirements, #117, pg. 52 117. The selected Offeror must provide a business rules engine to support access to the project-wide rules across systems based on the SOA (even though many of the systems and platforms already have built-in rule engines). The corresponding CMS MECT 2.2 Checklist requirement number is S&C.MS.16. 118. The selected Offeror must collaborate with MMIS 2020 Platform module contractors to maintain and synchronize all rules. If the EDI module has its own Business Rules

Can the Commonwealth describe how it envisions the various business rules engines would communicate among MMIS 2020 modules?

The SI/DH will house the Business Rules Engine (“BRE”), which will be developed during the DDI process for the MMIS 2020 Platform.

RFP #24-16


Q&A Engine (“BRE”), the selected Offeror must export and support the load of these rules in the central location. The corresponding CMS MECT 2.2 Checklist requirement numbers are TA.DM.1 and S&C.MS.10.


122

RFP, III-1. Requirements, F. Functional Requirements, #117, pg. 52 117. The selected Offeror must provide a business rules engine to support access to the project-wide rules across systems based on the SOA (even though many of the systems and platforms already have built-in rule engines). The corresponding CMS MECT 2.2 Checklist requirement number is S&C.MS.16. 118. The selected Offeror must collaborate with MMIS 2020 Platform module contractors to maintain and synchronize all rules. If the EDI module has its own Business Rules Engine (“BRE”), the

Can the Commonwealth clarify its intent for using the business rule engine relative to the EDI module? For instance, is the intent that the Offeror will provide the rules engine in this context to route and transform data?


RFP #24-16


Q&A selected Offeror must export and support the load of these rules in the central location. The corresponding CMS MECT 2.2 Checklist requirement numbers are TA.DM.1 and S&C.MS.10.


123

RFP, III-1. Requirements, F. Functional Requirements, #131, pg. 54 131. The selected Offeror must be able to send work objects to other MMIS 2020 Platform modules via the DH, add received work objects to workflow queue, and return updates, including a closure of the work object back to the originating Modules' workflow engine. No EDI-specific MECT 2.2 checklist requirement has been identified.

Can the Commonwealth describe how it envisions the workflow process among MMIS 2020 modules? How does this differ from the ESB that you plan to implement as part of the MMIS 2020 Platform?

The workflow and routing of data will be the responsibility of the SI/DH Contractor and will be finalized during DDI of the MMIS 2020 Platform in collaboration with all MMIS 2020 Module contractors.


124

RFP, III-1. Requirements, F. Functional Requirements, #131, pg. 54

Can the Commonwealth describe how it envisions the workflow process among MMIS 2020 modules? How does this differ from the ESB that you plan to implement as part of the MMIS 2020 Platform?


RFP #24-16


Q&A 131. The selected Offeror must be able to send work objects to other MMIS 2020 Platform modules via the DH, add received work objects to workflow queue, and return updates, including a closure of the work object back to the originating Modules' workflow engine. No EDI-specific MECT 2.2 checklist requirement has been identified.


125

RFP, III-1. Requirements, F. Functional Requirements, #76, pg. 46 76. The selected Offeror must lead and collaborate with the Commonwealth and across modules to establish the data architecture and processes for data management of the ODS. The corresponding CMS MECT 2.2 Checklist requirement number is IA.DMS.4.

Please clarify the expectation for the Offeror to "lead and collaborate with the Commonwealth and across modules to establish the data architecture and processes for data management of the ODS." It is unclear how leadership of the data architecture and data management of the ODS would relate to the scope of work defined for the EDI module.

The Department is removing this requirement.

RFP #24-16



126

RFP, III-1. Requirements, F. Functional Requirements, #93, pg. 48 93. The selected Offeror must provide an underlying DBMS so it is also available as a standalone query-able DBMS. No EDI-specific MECT 2.2 checklist requirement has been identified.

Does the Commonwealth intend to do reporting from the stand-alone DBMS that underlies the EDI transactions?

No.


127

RFP, III-1. Requirements, H. Tier 2 Technical Support, pg. 65 The selected Offeror must provide SMEs who can assist stakeholders with EDI-related issues for Tier 2 Technical Support. Stakeholders will communicate EDI-related issues to the Tier 1 Support Center by phone, web form, or email. When the Tier 1 Support Center is unable to resolve an EDI module-related issue, it will create and route a trouble ticket to the selected Offeror through a

Please define the tiers so that Offerors can determine the appropriate skill set to staff the call center. Please clarify who is providing Tier 1 and Tier 3 support.

Please see Appendix B - MMIS 2020 Platform Service Contractor and Module Description for Tier 1 Support Center and Appendix A for the MMIS 2020 Modularity diagram. Please refer to Sections III-1.F.16 and III-8.H for Tier 1 and Tier 2 requirements.

RFP #24-16


Q&A CRM tool for Tier 2 assistance. The selected Offeror must, at the minimum: 4. Escalate EDI trouble tickets that cannot be resolved to Tier 3 via CRM for resolution;


128

RFP, III-1. Requirements, F. Functional Requirements, #35, pg. 64 35. The Department has several MCOs as Authorized Trading Partners. The selected Offeror’s solution must support the Department’s MCO Authorized Trading Partners. Describe in detail your process for migrating the Department’s current MCOs Authorized Trading Partners to your solution. Explain the timeline from migration initiation to completion of integration into your solution. No EDI-specific MECT 2.2 checklist requirement has been identified.

Please provide the transaction types and formats that are currently being received from the MCO Authorized Trading Partners. Also identify any planned changes to the transaction types and formats.

837s in batch format and will continue to receive in the EDI Module.

RFP #24-16



129

RFP, III-1. Requirements, F. Functional Requirements, #75, pg. 46 75. The selected Offeror must utilize a configuration such that changes to modular data must remain in synchronization with the ODS. No EDI-specific MECT 2.2 checklist requirement has been identified

Please clarify the intent of this requirement. It is unclear what EDI module data would require synchronization with the ODS.

The EDI data is sent to the SI/DH, which then synchronizes with the ODS.


130

RFP, III-1. Requirements, F. Functional Requirements, #120, pg. 53 120. The selected Offeror must implement a BRE to store key Department rules, as well as to allow systems needing to externalize their business rules to have their own rule repositories within the shared BRE. No EDI-specific MECT 2.2 checklist requirement has been identified.

Please clarify the intent of the requirement to implement a BRE to store Department rules and the shared BRE requirement for systems that need to externalize their business rules. It is unclear how this requirement applies to the EDI module.

The EDI Module’s requirements for BRE include how data is accepted from the SI/DH, such as, specified date format, if applicable. The EDI contractor is responsible for the business rules related to the EDI module.

RFP #24-16



131

RFP, III-1. Requirements, F. Functional Requirements, #122, pg. 53 122. The selected Offeror must provide the ability for the workflow engine to capture business processes using Business Process Model and Notation 2.0 or later, even if the engine uses a separate coding of the rules for execution. The corresponding CMS MECT 2.2 Checklist requirement number is S&C.MS.18.

Please clarify the intent of this requirement. It is unclear how the ability to accommodate BPMN in the workflow engine applies to the EDI module.

Since each offeror will have a unique EDI solution, this requirement captures how the MMIS 2020 Platform will capture business processes.


132 Calendar of Events

Please provide anticipated date of contract award and/or specify the contract start date that Offerors should use for project planning purposes.

April 2019 is the anticipated effective date of the contract, but is subject to change.


133

Is there any work in this RFP that is related to other past or existing contracts? If so, please provide the contract numbers and their incumbents?

The Department’s current MMIS processes HIPAA transactions; however, no work has been done for the new MMIS 2020 Platform.


134

The contract work should be performed at the contractor owned/operated site or the government site?

Please refer to Section I-22 Department Participation. The selected offeror will have access to MMIS 2020 Platform project facilities.

RFP #24-16


Q&A


135 Technical Requirements #43, page 42

What specific inventory is the EDI module responsible to catalog in reference to utilizing the Service Oriented Architecture (SOA)? What constitutes the SOA in this context?

This requirement applies only for those SOAs specifically related to the EDI module.



Please provide list (or examples) of reference data required to be shared? Reference data is data that is required by other MMIS 2020 Platform modules, for example, diagnosis codes and procedure codes.



Please explain the use case supporting this requirement? Is this a one-way data synch from the EDI solution to the ODS?

This is a two (2) way data synch. Use cases will be developed during JADs in collaboration with the ITC/QA contractor, and SI/DH and other MMIS 2020 Platform contractors.



Please explain what is meant by reconcile with ODS? The data in the EDI module must match the data stored in the ODS. For example, the number of files sent by the EDI module to the ODS must match.



Please clarify the ODS data in scope in relation to the EDI module. Specific data for the EDI module stored in the ODS will be determined during Joint Application Design sessions.



Does the Commonwealth require COTS based BRE to be included as part of the EDI module or is the intent for the EDI solution to utilize a centralized BRE provided by the Commonwealth?

Both, business rule specific only to the EDI module will be stored within the EDI module. Business rules shared across modules will be stored on the SI/DH.

RFP #24-16




Please provide an example of a key Commonwealth rule? Business rules will be determined during Joint Application Design sessions and EDI module rules that are shared with other modules will be determined.


142 Functional Requirements #1, page 59

Please provide list of transactions that should be accommodated by the EDI solution outside of the standard HIPAA X12/NCPDP transaction set. The reference MECT requirements did not specify transactions outside of the standard set.

The Department may have transactions outside the standard HIPAA transaction set that will be defined during Joint Application Design sessions.



Is there a specific business use case driving this requirement, e.g. claims entry portal for providers?

Yes, it allows a provider to enter a single claim through the Provider Portal on the SI/DH for routing to the EDI module.



Does the Commonwealth intend to re-onboard existing trading partners? Yes.


145 Page 12 Please provide the number of direct and indirect trading partners. Refer to the response to Q.19.


146 Table 1: volume estimates, page 12

Please include transaction volume for the following: Batch:

270

271

276

277

278

835

837 inbound and outbound

In state fiscal year 16/17, the volumes for batch and real-time are as follows: 270/271 – 290 million 276/277 – Estimate unavailable 278 – 0 835 – 500,000 837 – 141 million NCPDP – 8 million

RFP #24-16


Q&A NCPDP

Real-time:

270

271

276

277

278

837 inbound and outbound

NCPDP


147 I-4 Objectives-A General, page 16

Will the SI/DH be responsible for providing the CORE compliant web service or should that be provided by the EDI module?

The SI/DH will host the web services gateway. The EDI module will send and receive data through the SI/DH.



For ERA/EFT reconciliation, does the Commonwealth anticipate the EDI solution to manage CORE Compliant rules of data content, timeliness, etc.?

Yes, the selected Offeror will be responsible with the SI/DH. Reconciliation will be further in JADS.



For Eligibility and Claim status transaction does the Commonwealth anticipate the EDI solution to manage CORE Compliant rules of data content, timeliness, etc.?



150 Appendix M – Cost Submittal Worksheet

Please clarify the difference between “Fixed Monthly Fee Prior to Maintenance & Operations” phase vs “Fixed Monthly Fee Maintenance & Operations” phase. Is “Fixed Monthly Fee Prior to Maintenance & Operations” referring to the implementation phase, whereas the “Fixed Monthly Fee Maintenance & Operations” is the on-going and maintenance phase?

The “Fixed Monthly Fee Prior to Maintenance & Operations” is for the design, development, and implementation phase. The “Fixed Monthly Fee Maintenance & Operations” is post implementation of the EDI module. The time period, shown in the cost summary, is based on Appendix C – MMIS 202 Platform

RFP #24-16


Q&A Please clarify which phase would the work items/deliverables associated costs be shown: “Fixed Monthly Fee Prior to Maintenance & Operations” or “Fixed Monthly Fee Maintenance & Operations”?

In the above cost sample entry, please clarify the reasoning why eight (8) months is shown for Year 2 “Fixed Monthly Fee Prior to Maintenance & Operations” phase, and four (4) months is shown for Year 2 “Fixed Monthly Fee Maintenance & Operations”.

Timeline. A revised Appendix M – Cost Submittal Worksheet is provided with this Addendum to the RFP.


151 Appendix M – Cost Submittal Worksheet

Depending on the clarification requested to question [150], if the contract

term as shown in the RFP is 3 years (pg. 23), and if the cost worksheet is showing ‘Fixed Monthly Fee Prior to Maintenance & Operations’ for 2 years,

then if the State does confirm that period is for implementation, then does

that mean the ‘live’ state is for just 1 year? With an option of an extension of

an additional year?

Alternatively, if that’s not the case, then what implementation timeline is the State expecting or can provide guidance on.

The “Fixed Monthly Fee Prior to Maintenance & Operations” is twenty (20) months from the contract effective date. The “Fixed Monthly Fee during Maintenance & Operations” begins on the 21st month of the contract with the implementation of the EDI module on the SI/DH (see Appendix C – MMIS 2020 Platform Timeline).

RFP #24-16




It is understood that offshore hosting is not acceptable. However, from the on-going technical support standpoint, does the Commonwealth allow ongoing technical support to include both onshore and offshore resources? If offshore is allowed, does PHI access have to be restricted? For example: Implementation support will use both onshore and offshore resources, however, absolutely no PHI will be accessed or exposed to any offshore resources.

Offshore resources are not allowed for ongoing technical support.



For the following statement: “The Offeror’s solution must support transactions other than the current ASC X12N and NCPDP HIPAA transactions. The corresponding CMS MECT 2.2 Checklist requirement numbers are IA.DS.1, IA.DS.2, IA.DS.6, IA.DS.7, IA.DS.12, IA.DS.21 and IA.DS.15 .“ It seems that the statement has been truncated. Is “IA.DA.1” intentionally mentioned twice, or was the second “IA.DS.1” instance partially truncated and was supposed to reference a different requirement number?

Please replace IA.DS.15 with IA.DS.5


154 General question regarding Offeror’s Response type and format (Ex: Functional Requirements #1 and 2, page 59).

From a response approach and format perspective, please clarify the Commonwealth’s expectation for the Offeror’s response.

We notice that many technical and functional requirements explicitly include

instructions for the Offeror to describe and/or explain how the solution

meets/exceeds/addresses/or accommodates the requirements. In such

instances (see the sample question #2 below), it is clear that the Commonwealth expects a descriptive response with full explanation on how

the Offeror’s proposed solution accommodates and meets the requirements.

On the other hand, there are also many technical and functional

requirements that do not include explicit instructions for the Offeror to give

No, Offerors must describe how they will meet all requirements and perform all tasks.

RFP #24-16


Q&A explanation, but rather set the expectation by stating that the selected Offeror must comply/adhere/implement/provide support etc. to meet the

requirements. In such instances, (see the below sample question #1 below), is the Commonwealth only primarily looking for an acknowledgement, or a

succinct Yes/No-type response for the Offeror’s response?

For example:

1. The Offeror’s solution must support transactions other than the current

ASC X12N and NCPDP HIPAA transactions. The corresponding CMS MECT

2.2 Checklist requirement numbers are IA.DS.1, IA.DS.2, IA.DS.6, IA.DS.7, IA.DS.12, IA.DS.21 and IA.DS.1

Offeror Response

2. The EDI module must assign each incoming and outgoing batch file a unique identification number. Please explain how your solution

accommodates this requirement. No EDI-specific MECT 2.2 checklist

requirement has been identified.

Offeror Response


155 General question Is the Offeror allowed to submit multiple bids?

If the Offeror were to submit a proposal as a prime, is the Offeror allowed to

submit a separate bid as a subcontractor?

No, the Offeror should submit its best solution in response to the RFP requirements. Yes, an Offeror who submits a proposal may also be a subcontractor to another Offeror.


156 General question Is clinical data intake a requirement for the EDI platform? Clinical data intake requirements will be determined during JADs, please see Section I-4 Objectives and Section I-31 Optional Expansion of EDI Services to include additional agencies or programs.

RFP #24-16



157 General question A number of states provide pricing guidance or levels that they would prefer the bids not to cross, is there similar guidance available here?

Additionally there is a reference in a March 2018 document around the MMIS

2020 project about “$3M per vendor for development of RFP requirement

development, evaluation, and contract negotiation’, does that have any

bearing on this RFP as well, and if so could you please elaborate.

Refer to the response to Q.1. No relationship exists.

RFP #24-16 MMIS Electronic Data Interchange Q&A...RFP #24-16 MMIS Electronic Data Interchange Q&A...

Documents

Transcript of RFP #24-16 MMIS Electronic Data Interchange Q&A...RFP #24-16 MMIS Electronic Data Interchange Q&A...