WI Dept of Health Services Request for Proposals, Revenue Maximization, May 2012

7/31/2019 WI Dept of Health Services Request for Proposals, Revenue Maximization, May 2012

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State of WisconsinDOA-3070 (R08/2003)s.16.75, Wis. Statutes

PROPOSALS MUST BE SEALED AND ADDRESSED TO:

AGENCY ADDRESS:

Jody Brassfield

Purchasing Manager

Department of Health Services

Division of Enterprise Services

1 W. Wilson Street, Room 665Madison, WI 53701-7850

REQUEST FOR PROPOSAL

Proposal envelope must be sealed and plainly marked in lower corner with due date and Req

for Proposal # 1722 DES-JB. Late Proposals will be rejected. Proposals MUST be date and

stamped by the soliciting purchasing office on or before the date and time that the Bid is

Proposals dated and time stamped in another office will be rejected. Receipt of a Proposal b

mail system does not constitute receipt of a Proposal by the purchasing office. Any Proposal w

is inadvertently opened as a result of not being properly and clearly marked is subject to rejec

Proposals must be submitted separately, i.e., not included with sample packages or

Proposals. Proposal openings are public unless otherwise specified. Records will be availab

public inspection after issuance of the notice of intent to award or the award of the conProposers should contact person named below for an appointment to view the Proposal rec

Proposals shall be firm for acceptance for sixty (60) days from proposal due date, unless othe

noted. The attached terms and conditions apply to any subsequent award.

THIS IS NOTAN ORDER Public OpeningProposals MUST be in this office no later than

2:00 PM CT June 13, 2012 No Public OpeningName (Contact for further information)

Jody BrassfieldPhone

608-267-4894

Date

May 11, 2012

BIDDER (Name and Address)

DescriptionThe purpose of issuing this Request for Proposal (RFP) is to establish a qualified list of RevenueMaximization contractors with expertise in one or multiple fields listed in this RFP. The Department thenintends to negotiate the award of multiple contracts with qualified Proposers within their respective fieldsprovide Revenue Maximization and related service(s) to the Department.

In order to establish this list of qualified vendors, Proposers will have to demonstrate their qualificationswithin their field of expertise as enumerated in the requirements of this RFP. This RFP also includes critunder which proposers must demonstrate proficiency. If proposer(s) satisfactorily meet the qualificationsthe respective field in which they respond, they will be regarded as eligible to enter into contractnegotiations with the Department as a qualified vendor for the field in which they have applied.

Payment Terms: Delivery Time:

We claim minority Bidder preference [Wis. Stats. s. 16.75(3m)]. Under Wisconsin Statutes, a 5% preference may be granted to CERTIFIED Minority Business Enterprises. Bidder must becertified by the Wisconsin Department of Commerce. If you have questions concerning the certification process, contact the Wisconsin Department of Commerce, 5th Floor, 201 W.Washington Ave., Madison, Wisconsin 53702, (608) 267-9550.

We are a work center certified under Wis. Stats. s. 16.752 employing persons with severe disabilities. Questions concerning the certification process should be addressed to the Work CenProgram, State Bureau of Procurement, 6th Floor, 101 E. Wilson St., Madison, Wisconsin 53702, (608) 266-2605.

Wis. Stats. s. 16.754 directs the state to purchase materials which are manufactured to the greatest extent in the United States when all other factors are substantially equal. Materials covered our bid were manufactured in whole or in substantial part within the United States, or the majority of the component parts thereof were manufactured in whole or in substantial part in the UnitedStates.

Yes No Unknown

n signing this Bid we also certify that we have not, either directly or indirectly, entered into any agreement or participated in any collusion or otherwise taken any action in restraint of freecompetition; that no attempt has been made to induce any other person or firm to submit or not to submit a Bid; that this Bid has been independently arrived at without collusion with any otherBidder, competitor or potential competitor; that this Bid has not been knowingly disclosed prior to the opening of Bids to any other Bidder or competitor; that the above statement is accurate undpenalty of perjury.

We will comply with all terms, conditions and specifications required by the state in this Request for Bid and all terms of our Bid.

Phone ( )Name of Authorized Company Representative (Type or Print) Title

Fax ( )

Social Security No. if Sole

Pro rietor (Voluntar )Signature of Above Date Federal Employer Identification No.


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State of Wisconsin Date: 05/11/12Dept. of Health Services RFP 1722 DES-JB Page 2 of 67

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REQUEST FOR PROPOSAL

STATE OF WISCONSINDEPARTMENT OF HEALTH SERVICESDIVISION OF ENTERPRISE SERVICES

RFP # 1722 DES-JB

Revenue Maximization Services

PROPOSALS MUST BE RECEIVED BY 2:00 PM CT WEDNESDAY, JUNE 13, 2012

LATE PROPOSALS WILL BE REJECTEDFAXED PROPOSALS WILL NOT BE ACCEPTED

THE STATE RESERVES RIGHT TO REJECT ANY AND ALL PROPOSALS


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TABLE OF CONTENTS

1.0 GENERAL INFORMATION .....................................................................................5

1.1 Introduction and Background ........................................................................5

1.2 Current Operations .......................................................................................5

1.3 DHS Overview ..............................................................................................61.4 Procuring and Contracting Agency ...............................................................8

1.5 Definitions .....................................................................................................8

1.6 Clarification and/or Revision to the Specifications and Requirements ..........9

1.7 Contract Quantities / New or Deleted Items................................................10

1.8 Reasonable Accommodations ....................................................................11

1.9 Calendar of Events .....................................................................................11

1.10 Contract Term and Funding ........................................................................11

1.11 VendorNet Registration...............................................................................12

1.12 Retention of Rights .....................................................................................12

1.13 Number of Contracts...................................................................................12

2.0 PREPARING AND SUBMITTING A PROPOSAL..................................................12

2.1 General Instructions....................................................................................12

2.2 Proposal Organization and Format .............................................................14

2.3 Multiple Proposals.......................................................................................16

2.4 Withdrawal of Proposals .............................................................................16

3.0 PROPOSAL SELECTION AND AWARD PROCESS ............................................16

3.1 Preliminary Evaluation ................................................................................16

3.2 Proposal Scoring ........................................................................................16

3.3 Evaluation Criteria ......................................................................................17

3.4 Best and Final Offer Process ......................................................................18

3.5 Notification of Intent to Pursue Contract Negotiations.................................18

3.6 Appeals Process .........................................................................................19

3.7 Right to Reject Proposals and Negotiate Agreement Terms.......................19

3.8 Cooperative Purchasing..............................................................................19

4.0 PROPOSER INFORMATION SECTIONS.............................................................20

4.1 RM and Related Services for Eligibility Initiatives Information Section........20

4.2 RM and Related Services for Benefit Initiatives Information Section ..........21

4.3 RM and Related Services for Administrative Human Services ProgramsInformation Section.....................................................................................22

4.4 RM and Related Services for Cost Reporting and Fed Claiming InitiativesInformation Section.....................................................................................23


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4.5 Contractual Requirements ..........................................................................24

5.0 TECHNICAL RESPONSE SECTION ....................................................................26

5.1 RM and Related Services Specific to Eligibility ..........................................26

5.2 RM and Related Services Specific to Benefit Initiatives..............................28

5.3 RM and Related Services Specific to Administrative Services....................305.4 RM and Related Services Specific to Cost Reporting and Federal Claiming

....................................................................................................................33

5.5 Areas of Qualification..................................................................................35

6.0 STANDARD AND SUPPLEMENTAL TERMS & CONDITIONS ............................36

6.1 Standard Terms and Conditions .................................................................36

6.2 Supplemental Terms and Conditions ..........................................................40

7.0 REQUIRED FORMS..............................................................................................417.1 Designation of confidential and Proprietary Information..............................42

7.2 Certificate Regarding Debarment and Suspension .....................................43

7.3 Wisconsin Cooperative Purchasing ............................................................44

7.4 Vendor Information .....................................................................................45

7.5 Vendor Reference.......................................................................................46

APPENDIX A Contract

APPENDIX B Business Associate Agreement

APPENDIX C Example of Current Engagement Letter


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1.0 GENERAL INFORMATION

1.1 Introduction and Background

The purpose of issuing this Request for Proposal (RFP) is to establish a qualified list of

Revenue Maximization contractors with expertise in one or multiple fields listed in this RFP.The Department then intends to negotiate the award of multiple contracts with qualifiedProposers within their respective fields to provide Revenue Maximization and relatedservice(s) to the Department.

In order to be included on this list of qualified vendors, Proposers will have to demonstratetheir qualifications within their field of expertise as enumerated in the requirements of this RFP.This RFP also includes criteria under which proposers must demonstrate proficiency. Ifproposer(s) satisfactorily meet the qualifications in the respective field in which they respond,they will be regarded as eligible to enter into contract negotiations with the Department as aqualified vendor for the field(s) in which they have applied.

Proposers providing such services are to identify and realize opportunities for claimingunanticipated federal or other revenues, maximizing other revenue sources, improving costreporting and federal claiming, improving program administration, and implementing programefficiencies. The new revenues would appropriately cover costs that were initially paid withstate or local funds that are eligible for federal or other reimbursement, or were initially paid inpart with federal funds that are appropriate and eligible for enhanced federal reimbursement. Itwill be the responsibility of the selected contractor or contractors to review and understandWisconsins current claiming procedures and how Wisconsin administers human servicesprograms, directly or through local agencies, to familiarize themselves with federal laws andregulations pertaining to these programs, to review the claiming of other states, and to develop

recommendations based on their research for the State of Wisconsin. DHS will review andapprove the recommendations developed and will authorize the contractor or contractors toproceed with the activities necessary for enhanced revenue generation, cost avoidance and/orrelated program efficiencies and/or technical assistance.

The purpose of this document is to provide interested parties with information to enable themto prepare and submit a proposal for providing Revenue Maximization and Related Services tothe State of Wisconsin as represented by the Department of Health Services (DHS). OtherState or local governmental agencies may acquire services under contract(s) issued as aresult of this request for proposal. The State desires to contract with multiple proposers forreview of programs and claiming of reimbursable expenditures under several programs

including but not limited to Medical Assistance Third Party Liability Programs, SupplementalNutrition Assistance Program, Substance Abuse, Aging, Mental Health and Public Healthprograms.

1.2 Current Operations

Currently DHS contracts with a single vendor, Public Consulting Group (PCG) for all RevenueMaximization and related services.


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1.3 Department of Health Services (DHS) Overview

The Department of Health Services (DHS) has many key responsibilities including medicalassistance and health care for low income families, elderly and disabled persons, the

Supplemental Nutrition Assistance Program (also known as FoodShare), long term supportand care programs, aging programs, physical and developmental disability programs, sensorydisability programs, mental health and substance abuse programs, operation of care andtreatment facilities, quality assurance programs, public health programs, regulation, andlicensing of a variety of facilities.

The DHS is one of the largest cabinet level agencies within the State of Wisconsin. This istrue in terms of human resources, revenue earned and spent, and federal funding allocations.The Departments programs affect the lives of nearly every Wisconsin citizen in one fashion oranother. The relevance of DHS efforts in collaboration with its hundreds of federal, county,municipal, and non-profit partners cannot be overstated. DHS serves as a foundation of the

States health and human services sector in topics that include policy development, funding,advocacy, direct patient care, and regulatory oversight.

The DHS employs nearly 6,000 people throughout the State of Wisconsin and manages abudget of over $9 billion dollars annually (Fiscal Year 2012). DHS manages 14 operationssites located across Wisconsin: five regional administrative offices, seven inpatient treatmentfacilities, one income maintenance delivery operation, and one headquarters facility located indowntown Madison.

DHS has a State-managed, locally-administered governance structure for many of its complexprograms. This means the nearly 100 local County and Tribal human services organizations

have a great deal of autonomy in their relationship with the Wisconsin Department of HealthServices. Local units of government provide part of the non-federal funding for certainprograms. While Wisconsin's human services and public health systems give a prominent roleto local partners in service delivery, expectations are that DHS will provide leadership,direction and oversight for those systems. If issues emerge in any part of the system, even iflargely locally based, public expectations are that DHS will be active in finding solutions,making program and system changes, and devising strategies to improve outcomes and avoidperformance lapses

Information on DHS and the programs it administers can be found athttp://www.dhs.wisconsin.gov/.

The Department is configured of six (6) divisions and four (4) offices as follows:

The Division of Health Care Access and Accountability The Division of Public Health The Division of Mental Health and Substance Abuse Services The Division of Long Term Care The Division of Quality Assurance The Division of Enterprise Services The Office of Policy Initiatives and Budget


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The Office of the Inspector General The Office of Legal Counsel The Office of the Secretary

The Division of Health Care Access and Accountability (DHCAA) develops andadministers the states public health care and nutrition supplementation programs for low

income persons, the elderly, and persons with disabilities. In fulfilling this mandate, the Divisionoversees the issuance of health care and nutrition benefits and manages the statewideeligibility determination system governing intake and monitoring of persons in these programs.In addition, it determines and adjudicates eligibility for persons applying for benefits underfederal Social Security disability insurance programs. DHCAA also administers the StatesMedicaid/BadgerCare Plus/ BadgerCare Plus Childless Adults programs, SeniorCareprescription drug benefit program, chronic disease program, Medicaid Well Women program,and the Health Care Tax Credit benefit program.

The Division of Long Term Care (DLTC) manages programs involving long term support andcare, aging, physical and developmental disabilities, and sensory disabilities, including theHome & Community Based Waiver and Family Care programs. In addition, the divisionoperates state institutions that provide care and treatment for persons with developmentaldisabilities.

The Division of Mental Health and Substance Abuse Services (DMHSAS) managesprograms that provide community mental health and substance abuse services. The divisionalso operates four state institutions that provide care and treatment for persons with mentalillness and/or sexually violent behavior. The Division is also responsible for clients rightsreviews and investigations and for the community forensics program.

The Division of Quality Assurance (DQA) assures the safety, welfare and health of personsutilizing health, long-term care and community-care provider services. The division assuresquality of care and quality of life through the development of rules and standards, on-siteinspections (surveys), complaint investigations, enforcement activities, facility plan reviews,training, policy interpretations, best practice initiatives, nurse aide registration, caregiverbackground checks and investigations, provider information and education, proactiverelationships among providers and consumers, and through the development of rules andstandards.

The Division of Public Health (DPH) manages programs in the areas of environmentalhealth, occupational health, family and community health, injury prevention, chronic diseaseprevention, health promotion, communicable disease prevention and preparedness,emergency medical services, research and evaluation, e-Health, public health preparednessand health information.

The Division of Enterprise Services (DES) provides management support in the areas offiscal services, information and technology services, purchasing and contract administration,intergovernmental relations, personnel, affirmative action and employment relations,institutional support services, internal audit and project management to the program divisionsof the Department.

The Office of Policy Initiatives and Budget (OPIB) provides department-wide budgeting,policy development and implementation. It is also responsible for management of tribal affairs.


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The Office of the Inspector General (OIG) has department wide responsibilities for auditingthe use of department funds in support of the department's commitment to be an effectivesteward of the public resources DHS is entrusted to manage. The OIG, which reports directlyto the DHS Secretary, conducts audits of providers who receive department funds, performsinternal audits of department programs and operations, and investigates allegations of fraud,waste, or abuse of DHS resources by contractors, providers and recipients. The OIG also isresponsible for working with DHS program divisions and partners to develop policies andpractices to prevent fraud, waste and abuse.

The Office of Legal Counsel (OLC) is the office providing the Department with legal adviceand representation. The Office provides formal legal opinions, informal legal advice, andlitigates DHS cases in administrative hearings and in some court proceedings. The Officecoordinates DHS rulemaking activities, administers DHS compliance with HIPAA regulationsand other privacy laws, coordinates the Departments rehabilitation review approval process,and provides training and guidance in investigation methods and legal issues.

The Office of the Secretary oversees all divisions and programs within the Department.

1.4 Procuring and Contracting Agency

The Wisconsin Department of Health Services, Division of Enterprise Services (DES), Bureauof Fiscal Services, issued this Request for Proposal (RFP), which is the sole point of contactfor the State of Wisconsin during the Proposal process. The person responsible for managingthe procurement process is Jody Brassfield.

DES will administer the contract resulting from this RFP. The contract administrator will beCheryl K. Johnson or designee.

1.5 Definitions

Throughout the RFP, the following terms are used and are defined as:

1. Agency, Department, or DHS means the Wisconsin Department of Health Services.

2. Agreement and Contract (used interchangeably) means the final written contractnegotiated between DHS and the contractor(s).

3. Contractor(s) means proposer(s) or vendor(s) awarded final contract. The singularand plural forms are used interchangeably within this document and do not imply any

predetermination of whether a single or multiple proposers will be offered a contractunder this RFP. That determination will be based on the results of the evaluation ofproperly submitted proposals and to the benefit of the State.

4. DOA: is defined as the Department of Administration.

5. HIPAA: is defined as the Health Insurance Portability and Accountability Act of 1996.

6. Medicaid: is defined as all programs funded in whole or in part under Title 19 of theSocial Security Act and associated State and/or other public funds.


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7. MBE: is defined as Minority Business Enterprise

8. Proposer/Vendor means a firm submitting a proposal in response to this RFP.

9. Revenue Maximization: Initiatives that reduce State expenditures by increasing federalmatching funds or initiatives that decrease State expenditures for services provided.

10. RFP: is defined as Request for Proposal

11. RM: Is defined as Revenue Maximization

12. SCHIP: means the federal State Childrens Health Insurance Program funded underTitle 21 of the Social Security Act and associated State and/or other public funds.

13. SNAP: means the federal Supplemental Nutrition Assistance Program. In Wisconsin,the program is known as FoodShare.

14. SPA: State Plan Amendment

15. State means the State of Wisconsin.

16. Subcontract: A written agreement between the contractor and a subcontractor toprovide services.

17. Subcontractor: A third party who contracts with the awarded contractor for theprovision of services, which the contractor has contracted with the Department toperform.

1.6 Clarification and/or Revisions to the Specifications and Requirements

Any questions concerning this RFP must be submitted to Jody Brassfield, Purchasing Managerat:

[email protected]

Written questions must be submitted before 4:30 PM CT on Friday, May 25, 2012. Allquestions are to be submitted in non-protected Microsoft Word format with the followingsubject line listed below:

Subject Line: Question 1722 DES-JB Company Name

Telephone questions will not be accepted. Any oral responses, information, dates, and/ortechnical assistance received by a prospective Proposer from the Department or Departmentstaff shall not, in any manner whatsoever and whether before or after the release of this RFP,be binding on the State of Wisconsin, unless followed-up and explicitly confirmed and stated inwriting by the State.

Vendors are expected to raise any questions, exceptions, or additions they have concerningthe RFP document at this point in the RFP process. If a vendor discovers any significant


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ambiguity, error, conflict, discrepancy, omission, or other deficiency in this RFP, the vendorshould immediately notify the above named individual of such error and request modification orclarification of the RFP.

In the event that it becomes necessary to provide additional clarifying data or information, or torevise any part of this RFP, revisions/amendments and/or supplements will be providedthrough the State VendorNet system.

Each Proposal shall stipulate that it is predicated upon the requirements, terms, and conditionsof this RFP and any supplements or revisions thereof.

Any contact with State employees concerning this RFP is prohibited, except asauthorized by the RFP manager during the period from date of release of the RFP untilthe notice of intent to award is released.

1.7 Contract Quantities / New or Deleted Items

The buying agency does not guarantee to purchase any specific quantity of services.

Proposals that require the State to guarantee a specific quantity or dollar amount may bedisqualified.

NEW OR DELETED ITEMS: The agency reserves the right to add new related services to thiscontract based on changes in need or changes to standards unknown at the time of this RFP.Qualified contractors will be asked to provide pricing for new related services and those priceswill be formalized by contract amendment. Contractor(s) prices must be comparable to currentcontract pricing for like services.

The contractor shall not have exclusive rights to provide all services covered under thiscontract during the term of the contract or any extension of the contract.

1.7.1 Post RFP Work Product Award

Once a list of qualified vendors has been established for each field, via the methodsdescribed in Section 3.0. The Department will request revenue maximizationmethodologies and cost estimates for individual projects from the respective list ofqualified vendors.

There are two methods typically used for developing a revenue maximization project:

1) Request initiated by the Department and issued to the contractor(s) for

development of methodologies and a proposed rate within the establishedrate; or

2) Potential project proposed by the contractor, including methodology and aproposed rate.

Regardless of the method in which the revenue maximization project is developed, allprojects will be formatted in the form of an engagement letter (reference Appendix C)describing a detailed work plan, measurable deliverables and rate structure. For workprojects DHS wishes to pursue, proposed engagement letters will be requested from thequalified list of contractors within their respective field. This distribution will take place


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regardless of whether the project was originated by the Department or one of thequalified contractors. Respective certified contractors will then independently review theproject and will have an opportunity to propose their work plan, deliverables, cost rate,and detailed pricing methodology for each project. Based on the revenue maximizationmethodology and the costs proposed from one or more certified contractors, theDepartment will determine whether to proceed with the project. If the Departmentdecides to pursue a project, it shall award the project to the contractor based on theDepartments assessment of the methodology proposed and an estimate of the level ofpredicted revenue enhancement, direct costs, or a combination thereof.

By submitting a response to this RFP, Proposers are agreeing to the methoddescribed above to award work to the contractors on the qualified list establishedas a result of this RFP.

1.8 Reasonable Accommodations

DHS will provide reasonable accommodations, including the provision of informational material

in an alternative format, for qualified individuals with disabilities upon request. To request suchaccommodations at any time during the RFP process, contact Jody Brassfield at (608) 267-4894 or [email protected] .

1.9 Calendar of Events

Listed below are specific and estimated dates and times of actions related to this RFP. Theactions with specific dates must be completed as indicated unless otherwise changed by theState. In the event that the State finds it necessary to change any of the specific dates andtimes in the calendar of events listed below, it will do so by issuing a supplement to this RFPand posting it to the State of Wisconsin purchasing and vendor notification website

(VendorNet) at http://vendornet.state.wi.us . There may or may not be a formal notificationissued for changes in the estimated dates and times.

DATE EVENTMay 11, 2012 Date of issue of the RFB (Posted to

VendorNet)May 25, 2012 Deadline for Written QuestionsMay 31, 2012 (estimated) All Questions and Answers posted to

VendorNetWednesday, June 13, 2012 2:00

PM CT

Proposals due from vendors

July 13, 2012 (estimated) Notification of intent to pursuecontract negotiations

July August (estimated) Contract NegotiationsAugust 1, 2012 Contract Start Date

1.10 Contract Term and Funding


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The contract shall be effective on the date indicated in the contract and shall run for (one) yearfrom that date with an option by mutual agreement of the agency and contractor, to renew for(4) four additional one (1) year periods.

Any Contract resulting from this RFP shall not be, in whole or in part, subcontracted, assigned,or otherwise transferred to any other Contractor without prior written approval from theDepartment. Reference Section 4.5.

1.11 VendorNet Registration

The State of Wisconsins purchasing information and vendor notification service is available toall businesses and organizations that want to sell to the state. Anyone may access VendorNeton the Internet at http://vendornet.state.wi.us to get information on state purchasing practicesand policies, goods and services that the state buys, and tips on selling to the state. Vendorsmay use the same Web site address for inclusion on the Bidder list for goods and services thatthe organization wants to sell to the state. A subscription with notification guarantees theorganization will receive an e-mail message each time a state agency, including any campus

of the University of Wisconsin System, posts a request for Bid or a request for Proposal in theirdesignated commodity/service area(s) with an estimated value over $50,000. Organizationswithout Internet access receive paper copies in the mail. Increasingly, state agencies also areusing VendorNet to post simplified bids valued at $50,000 or less. Vendors also may receivee-mail notices of these simplified bid opportunities.

1.12 Retention of Rights.The State of Wisconsin retains the right to accept or reject any or all proposals if it is deemedto be in the best interest of the State of Wisconsin.

If mutually agreed to by the contractor, and the State, the results of this solicitation may be

used by other Wisconsin agencies, including local units of government and/or other states,including their local units of government.

All proposals become the property of DHS upon receipt. All rights, title and interest (includingthe right to exploit for the States purposes) in all materials and ideas prepared by the Proposerfor the proposal to DHS shall be the exclusive property of DHS and may be used by the Stateat its option.

1.13 Number of Contracts

It is the intention of the Department to award multiple contracts for the service areas identified

in Sections 4.1 through 4.4. However, the contractor shall not have exclusive rights to provideall services covered under this contract during the term of the contract or any extension of thecontract.

2.0 PREPARING AND SUBMITTING A PROPOSAL

2.1 General Instructions


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The selection of a contractor will be based on the information submitted in the vendor'sProposal. Failure to respond to each of the requirements in the RFP may be the basis forrejecting a Proposal.

Elaborate Proposals (e.g., expensive artwork), beyond what is sufficient to present a completeand effective Proposal are not necessary or desired.

The State of Wisconsin is not liable for any cost incurred by Proposers in replying to this RFP.

Proposers must submit Proposals in strict accordance with the requirements set forth in thissection. All materials must be submitted to:

Jody BrassfieldPurchasing ManagerDepartment of Health ServicesDivision of Enterprise Services1 W. Wilson Street, Room 665Madison, WI 53701-7850

(608) 267 4894

All materials must be received in the prescribed formats by 2:00 PM CT Monday, May 21,2012.

Proposals must be received in the above office by the specified date and time stated below.All Proposals must be stamped as accepted by the Purchasing Manager or designee. Receiptof a Proposal by the State mail system does not constitute receipt of a Proposal by thePurchasing Office, for purposes of this RFP. No proposals are allowed to be submitted by faxor email; any proposal submitted by fax or e-mail will be rejected.

There are two components needed for complete submission of the Proposals: Paper (HardCopies) and Electronic. Both components are due to the address above by the stated dateand time. The following submission requirements must be followed for each of thecomponents:

Paper (Hard Copy) Proposal Components

This component must contain the original and three (3) paper copies of the entire TechnicalProposal (Section 2.2.2 Proposal Organization and Format) including any proprietaryinformation. No mention of cost is to be included in this component, referencing of costin this component may be grounds for rejection of proposal.

Electronic Proposal Components

In addition to the paper documents described above, the Proposal must be submitted in non-password protected PDF format on reproducible CDs recorded and labeled as follows:

Disc Onemust contain the entire Proposal including any proprietary informationand have the following label affixed to the disc:

Technical Proposal Proprietary Information Included


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Name and Address of Proposer

RFP 1722 DES-JB

Disc Twomust contain the entire Proposal excluding the proprietary informationreported on the Designation of Confidential and Proprietary Information form

(DOA-3027). Note: The Department in responding to open records requests willrelease the information on this disc. It is the sole responsibility of the Proposer toensure that there is no conflict between the Designation of Confidential andProprietary Information form (DOA-3027) and the information provided on thisdisc. The following label must be affixed to the disc:

Technical Proposal Proprietary Information Excluded


Name and Address of Proposer

RFP 1722 DES-JB

2.2 Proposal Organization and Format

Technical proposals must be organized into clearly delineated sections, as shown below.Each heading and subheading should be separated by tabs or otherwise clearly marked.

No mention of the cost proposal may be made in the response to the Technical Requirementsof this Request for Proposal.

Sections 5.1 through 5.4 (Tabs 3 6) are the specific areas of focus for the departmentrelating to Revenue Maximization. Proposers are required to respond only to those sections in

5.1 through 5.4 in which they would like the opportunity to be evaluated for an opportunity tobe eligible for placement on Departments qualified list of vendors for these areas of RevenueMaximization.

Proposers must respond to Sections 5.5 with a descriptive narrative, which includesmethodology to the level of detail deemed appropriate by the proposer andappropriately labeled as referenced below.

Tab 1. Table of Contents (Mandatory)

Tab 2. Proposer Information Sheet (Mandatory)

a. Cover Sheet DOA-3070

b. Vendor Information Form DOA-3477

c. Transmittal Letter

d. Designation of Confidential and Proprietary Information Form DOA-3027

e. Vendor Information Form DOA-3477


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f. Cooperative Purchasing Form DOA-3333

Tab 3. RM and Related Services Specific to Eligibility

a. Experience, Demonstrated Abilities and Expertise in fulfillment of therequirements in Section 5.1.1 5.1.7

Tab 4. RM and Related Services Specific to Benefit Initiatives


Tab 5. RM and Related Services Specific to Administering Human Services Programs


Tab 6. RM and Related Services Specific to Cost Reporting and Federal Claiming


Tab 7. Areas of Qualification (Mandatory)

a. Provided a detailed description of proposers Experience, Demonstrated Abilities,and Expertise in the areas in section 5.5.1 5.5.3.

All materials must be received in the prescribed formats by 2:00 PM CT Monday, May21, 2012

2.2.1 Transmittal Letter

A Transmittal Letter must accompany the RFP package. It must be on officialbusiness letterhead of the prime Proposer submitting the Proposal, and must besigned in ink by an individual authorized to legally bind the Proposer.

The Transmittal Letter must stipulate the following:

The Proposer is the prime Contractor and is a corporation or otherlegal organization;

Services that the Contractor intends to sub-contract to anotherentity;

No attempt has been made or will be made by the Proposer toinduce any other person or firm to submit or not to submit aProposal;

Proposer certifies they have not directly or indirectly, entered intoany agreement or participated in any collusion or otherwise takenany action in restraint of free competition; that this Proposal hasbeen independently arrived at without collusion with any other


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Proposer, competitor or potential competitor; that this proposal hasnot been knowingly disclosed prior to the opening of proposals toany other proposer or competitor.

The Proposal is valid for a minimum of 60 Days from the Proposaldue date;

The person signing this letter and all RFP documents is authorizedto make decisions on behalf of the Proposing organization and thatthe person has not participated, and will not participate, in anyaction contrary to the this statement;

Assurance that the Proposer will agree to execute and fulfill acontract according to the conditions and terms specified in thisRFP;

That the Proposal is predicated upon the requirements, terms, andconditions of this RFP, the posted Questions and Answers, all itsattachments, and any supplements or revisions thereof; and

That an individual authorized to bind legally the Proposer hassigned this Transmittal Letter.

2.3 Multiple Proposals

Submission of multiple Proposals from a vendor is not permissible.

2.4 Withdrawal of Proposals

Proposals shall be irrevocable until contract award unless the Proposal is withdrawn.Proposers may withdraw a Proposal in writing at any time up to the Proposal closing

date and time or upon expiration of five (5) business days after the due date and time ifreceived by the RFP Purchasing Manager. The written request must be signed by anauthorized representative of the Proposer and submitted to the RFP PurchasingManager at the address listed in Section 2.1 General Instructions. If a previouslysubmitted Proposal is withdrawn before the Proposal due date and time, the Proposermay submit another Proposal at any time up to the Proposal closing date and time.

3.0 Proposal Selection and Award Process

3.1 Preliminary Evaluation

The purpose of the preliminary evaluation is to determine if each proposal is sufficientlyresponsive to the RFP to permit a complete evaluation. Proposals must comply with theinstructions to vendors contained in this RFP. Failure to comply with the instructionsmay cause the proposal to be rejected without further consideration. The state reservesthe right to waive any minor irregularities in the proposal.

3.2 Proposal Scoring

Proposals accepted through the preliminary evaluation process will be reviewed by anevaluation committee and scored against the chosen criteria. A proposer may not


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contact any member of an evaluation committee except with the ProcurementManagers written approval.

The committee may review references, request interviews, and/or perform financialstability and/or litigation analysis, and use the results in evaluating the proposals. TheState reserves the right to check any reference(s), regardless of the source of thereference information, including but not limited to, those that are identified by thecompany in the proposal, those indicated through the explicitly specified contacts, thosethat are identified during the review of the proposal, or those that result fromcommunication with other entities involved with similar projects.

Information to be requested and evaluated from references may include, but is notlimited to, some or all of the following: project description and background, jobperformed, functional and technical abilities, communication skills and timeliness, costand schedule estimates and accuracy, problems (poor quality deliverables, contractdisputes, work stoppages, et cetera), results of federal or other audits, overallperformance, and whether or not the reference would rehire the firm or individual. Onlytop scoring Proposals will receive reference checks and negative references may

eliminate proposers from consideration for award.

Proposals from certified Minority Business Enterprises may have points weighted by afactor of 1.00 to 1.05 to provide up to a five percent (5%) preference to thesebusinesses (Wis. Stats. 16.75(3m)). The evaluation committee's scoring will betabulated and proposals ranked based on the numerical scores received.

3.3 Evaluation Criteria

Sections 5.1 through 5.4 will be scored as individual sections and awards will be

recommended based on the scores of each individual section. Section 5.5 will be givena score of 0-100 points, that score will be added to each the scores in section 5.1through 5.4 to reach a total score. If the Total Score for each section is less then 50%after adding the Section 5.5 score (Total Possible Score) the proposers will not berecommended for a contract award in that section. This threshold will apply withoutexception.

Description Percent Max Points1. Eligibility Initiatives (Section 5.1) 83% 4802. Benefit Initiatives (Section 5.2) 83% 4803. Administrative Services (Section 5.3) 83% 480

4. Cost Reporting and Federal Claiming (Section 5.4) 83% 4805. Areas of Qualification (Section 5.5)* 17% 100

The score given to the response in Section 5.5 will apply to allsection(s) in which the vendor chooses to respond. Referenceexample below.

EXAMPLE SCORE SHEETVendorName

ResponseSection

ResponseSection Score

Area of QualificationScore (Section 5.5)

TotalScore

AwardRecommendation


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ABCConsulting

5.1 400 70 Points 47081% YES(470/580)

ABCConsulting

5.2 DNP DNP DNP DNP

ABCConsulting

5.3 215 70 Points 28549% NO(285/580)

ABCConsulting 5.4 425 70 Points 495

85% YES(495/580)

XYZConsulting

5.1 300 30 Points 330 57 % YES(330/580)

XYZConsulting

5.2 450 30 Points 480 83 % YES(480/580)

XYZConsulting

5.3 470 30 Points 500 86% YES(500/580)

XYZConsulting

5.4 265 30 Points 295 51 % YES(295/580)

DNP = did not propose

In the example above, Proposer ABC Consulting would be recommended for award in Section5.1 Eligibility Initiatives and Section 5.4 Cost Reporting and Federal Claiming.

XYZ Consulting would be recommended for award in Section 5.1 Eligibility Initiatives, Section5.2 Benefit Initiatives, Section 5.3 Administrative Services and Section 5.4 Cost Reporting andFederal Claiming.

3.4 Best and Final Offer Process

The Department reserves the right to exercise the Best and Final Offer process;however, proposers should not expect the Department will request a best and final offer.

If best and final offers are requested by the Evaluation Committee or the PurchasingLead, the request will be in compliance with PRO-C-39 Best and Final Offer Processand Procedures, Procurement Manual, Wisconsin State Bureau of Procurement.

See the following link for more detail:http://vendornet.state.wi.us/vendornet/procman/index.asp

3.5 Notification of Intent to Pursue Contract Negotiations

All vendors who respond to this RFP will be notified via email of the State's intent topursue contract negotiations as a result of this RFP.

After notification of the intent is made and under the supervision of agency staff, copiesof proposals will be available for public inspection from 8:00 a.m. to 4:00 p.m. at OneWest Wilson Street, Room 665, Madison, Wisconsin. Vendors should schedule reviewswith Jody Brassfield (608) 267-4894.


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3.6 Appeals Process

Notices of intent to protest must be made in writing to the Secretary of the Departmentof Health Services. Protestors must identify State Statute and Wisconsin Administrative

Code provisions that are alleged to have been violated.

Any written notice of intent to protest the intent to award a contract must be filed with:

Dennis G. Smith, SecretaryDepartment of Health ServicesOne West Wilson StreetPO Box 7850Madison, WI 53701-7850

A notice of intent to protest must be received in the Secretarys Office no later than five

(5) working days after the notices of intent to award are issued.

Any written protest must be received in the same office within ten (10) working daysafter the notice of intent to award is issued.

The decision of the Secretary of DHS may be appealed to the Secretary of theDepartment of Administration within five (5) working days of issuance with a copy ofsuch appeal filed with DHS. The appeal must allege a violation of a Wisconsin statuteor a section of the Wisconsin Administrative Code.

3.7 Right to Reject Proposals and Negotiate Agreement Term

The State reserves the right to reject any and all Proposals. The State may negotiatethe terms of the contract, including the award amount, with the selected Proposers priorto entering into a contract. If contract negotiations cannot be concluded successfullywith the recommended Proposers or upon unfavorable review of the Proposersreferences, the Department may terminate contract negotiations.

The Departments purchasing agent or designee will review each Proposal to verify theProposer meets the requirements specified in this RFP based on a pass or fail protocol.This determination is the sole responsibility of the Department.

3.8 Cooperative Purchasing

Upon mutual agreement of both Proposer and the Department the same pricing, terms,and conditions, resulting from this RFP may be extended to the entities as defined inWisconsins Cooperative Purchasing Service Vendor Agreement DOA-3333 (ReferenceSection 7.0 Required Forms)


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4.0 PROPOSER INFORMATIONAL SECTIONS

Section 4.0 contains information for Proposers regarding the responsibilities, deliverables andoutcomes a contractor is responsible for providing under the Revenue Maximization contract.

The following requirements are the minimum specifications and areas of responsibilitiesrequired. Sections 4.1 through 4.4 are the specific areas of focus for the department relatingto Revenue Maximization. Proposers are not required to have expertise in all areas ofsections 4.1 through 4.4, rather only in those sections in which they intend to respond followingthe protocol described in Section 5.0. Proposers are not to respond to Sections 4.1 through4.4; proposers are expected to use the information contained in Sections 4.1 through 4.4 tohelp them better understand the expected scope of work required under the RevenueMaximization contract.

If no Proposers are able to comply with a given specification, condition of proposal or provide aspecific item, the state reserves the right to delete that specification, condition of proposal or

item.

Vendors will be expected to provide all necessary resources to propose, develop, and executeinitiatives.

The following are the specific areas of focus for the Department related to RevenueMaximization.

Revenue Maximization and Related Services specific to eligibility.

Revenue Maximization and Related Services specific to benefits

Revenue Maximization and Related Services specific to administering humanservices programs

Revenue Maximization and Related Services specific to cost reporting andFederal claiming

4.1 RM and Related Service for Eligibility Initiatives Information Section

DHS conducts a wide variety of activities in the area of SNAP and Medicaid eligibility.Proposers will be required to possess the following experience, demonstrated abilities and

expertise in providing Revenue Maximization work products and related services in the area ofeligibility.

Past revenue maximization projects related to eligibility have included projects to improve theSNAP error rate.

The contractor must have the demonstrated experience and ability to develop, implement andsuccessfully complete revenue maximization initiatives related to eligibility for human servicesprograms, including but not limited to:


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4.1.1 Providing revenue maximization services to government or business entitiesspecifically in the area of eligibility for human services programs, especially forSNAP, Medicaid and SCHIP funded programs.

4.1.2 Developing and implementing detailed strategies for revenue maximizationeligibility initiatives for human services programs including:4.1.2.1 Establishing and maintaining a detailed project plan for how the

vendor will accomplish the RM initiative.4.1.2.2 Identifying all parties involved in the RM initiative and establishing

their roles and responsibilities in the RM Initiative.4.1.2.3 Establishing contact information of key personnel assigned to the

initiative and assuring their availability when and as needed withinthe approved project plan.

4.1.2.4 Identifying and securing subcontractors needed to supplementvendor and state resources during the RM initiative.

4.1.3 Developing and successfully negotiating detailed Federal SPAs and relatedcommunications for RM eligibility initiatives.

4.1.4 Developing detailed timelines for all of the activities involved in the RM eligibilityinitiative, including negotiating the availability of critical customer or subcontractorstaff. Original and updated timelines must be documented within the project planand approved by the customer.

4.1.5 Developing detailed fee structures used in the RM eligibility initiative.

4.1.6 Calculating and explaining estimated savings anticipated for each RevenueMaximization initiative.

4.1.7 Preparing and explaining the final report of actual savings generated and anassessment of the strategies for used for each initiative completed.

4.2 RM and Related Service for Benefits Initiatives Information Section

DHS provides a wide variety of benefits as part of members eligibility in SNAP and Medicaid.Proposers will be required to possess the following experience, demonstrated abilities andexpertise in providing Revenue Maximization work products and related services in the area ofbenefits.

Past revenue maximization initiatives have included projects to implement and standardizedtargeted case management claiming and to increase recoveries from liable third parties.

The contractor must have the demonstrated experience and expertise to develop, implementand successfully complete revenue maximization initiatives related to provision of humanservice program benefits including, but not limited to:

4.2.1 Providing revenue maximization services to government or business entitiesspecifically related to administration of human services benefits/benefit plans.

4.2.2 Developing and implementing detailed strategies for revenue maximizationrelated to benefits/benefit plan administration services including


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4.2.2.1 Establishing and maintaining a detailed project managementplan for how the contractor will accomplish the goals of therevenue maximization initiative.

4.2.2.2 Identifying all parties involved in the revenue maximizationinitiative and establishing their roles and responsibilities in theRM Initiative.

4.2.2.3 Establishing contact information of key personnel assigned tothe initiative and assuring their availability when and as neededwithin the approved project plan.

4.2.2.4 Identifying and securing subcontractors needed to supplementcontractor and state resources during the RM initiative

4.2.3 Developing and successfully negotiating detailed Federal SPAs and relatedcommunications for RM initiatives.

4.2.4 Developing detailed timelines for all of the activities involved in the RM benefitsinitiative, including negotiating the availability of critical customer or subcontractorstaff. Original and updated timelines must be documented within the project planand approved by the customer.

4.2.5 Developing detailed fee structures used in the RM benefit initiative.

4.2.6 Calculating and explaining estimated savings anticipated for each RevenueMaximization initiative.

4.2.7 Preparing and explaining the final report of actual savings generated and anassessment of the strategies for used for each initiative completed.

4.3 RM and Related Services for Administering Human Services ProgramsInformation Section :

DHS administers a wide range of programs, including FoodShare, Medicaid, SubstanceAbuse Prevention and Treatment programs, Environmental and other Public Healthprograms, etc. DHS provides direct client services through the operation of mentalhealth facilities and developmental disabilities centers. Programs, such as disabilitydeterminations, are administered directly by DHS; while others such as the Women,Infant and Children Supplemental Nutrition Program (WIC) are supervised by DHS andadministered through local agencies. Programs are, in some cases, administered jointlyor under memoranda of understanding by DHS and other state agencies, such as theUniversity of Wisconsin-Madison or the Department of Children and Families.

Proposers will be required to possess the following experience, demonstrated abilities

and expertise in providing Revenue Maximization work products related to administeringhuman services programs. The experience and expertise requirements include, but arenot limited to:

4.3.1 Providing revenue maximization services to government or businessentities specifically in the area of improved administration of and fundingfor administering human services programs.

4.3.2 Developing and implementing detailed strategies for revenuemaximization initiatives related to improving administration of and fundingfor administering human services programs including


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4.3.2.1 Establishing and maintaining a detailed project plan for how the

vendor will accomplish the RM initiative.4.3.2.2 Identifying all parties involved in the RM Initiative and

establishing their roles and responsibilities in the RMS Initiative.4.3.2.3 Establishing contact information of key personnel assigned to

the initiative and assuring their availability when and as neededwithin the approved project plan.

4.3.2.4 Identifying and securing subcontractors needed to supplementvendor and state resources during the RM initiative

4.3.3 Developing and successfully negotiating detailed Federal State PlanAmendments, Cost Allocation Plan Amendments and similar documentsrequiring federal approval and any related communications for the RMinitiative.

4.3.4 Developing detailed timelines for all of the activities involved in the RMinitiative to improve administration of or funding for the administration ofprograms, including negotiating the availability of critical customer or

subcontractor staff. Original and updated timelines must be documentedwithin the project plan and approved by the customer.

4.3.5 Developing detailed fee structures used in the RM initiative related toadministration of human services programs.

4.3.6 Calculating and explaining estimated savings anticipated for distinctRevenue Maximization initiatives.

4.3.7 Preparing and explaining the final report of actual savings generated andan assessment of strategy for used for each of the initiatives completed.

4.4 RM and Related Services for Cost Reporting and Federal Claiming InitiativesInformation Section

DHS administers a wide range of programs, including SNAP and Medicaid. Proposerswill be required to possess the following experience, demonstrated abilities andexpertise in providing Revenue Maximization work products related to Cost Reportingand Federal Claimingservices.

Past revenue maximization initiatives related to cost reporting and federal claiming haveincluded cost settlement with local units of government and other state agencies for

various services and review of certain cost reporting/allocation functions.

The required experience and expertise include, but are not limited to:

4.4.1 Providing services to governments or other business entities to improvecost reporting and Federal claiming. Improve cost reporting and federalclaiming includes, but is not limited to, streamlining operations andimproving results of work efforts.


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4.4.2 Developing and implementing detailed strategies for improving costreporting and Federal claiming:4.4.2.1 Establishing and maintaining a detailed project plan for how the

vendor will improve cost reporting and/or federal claiming.4.4.2.2 Identifying all parties involved in improving cost reporting and/or

federal claiming and establishing their roles and responsibilitiesof all parties.

4.4.2.3 Establishing contact information of key personnel assigned tothe initiative and assuring their availability when and as neededwithin the approved project plan.

4.4.2.4 Identifying and securing subcontractors needed to supplementcontractor and state resources during the RM initiative

4.4.3 Developing and successfully negotiating detailed Federal Cost AllocationPlan updates or other changes needed for improved federal claiming andrelated communications.

4.4.4 Developing detailed timelines for all of the activities involved in the RMCost Reporting and Federal Claiming initiative, including negotiating the

availability of critical customer or subcontractor staff. Original andupdated timelines must be documented within the project plan andapproved by the customer.

4.4.5 Developing detailed fee structures used in the RM Cost Reporting andFederal Claiming initiative.

4.4.6 Calculating and explaining estimated savings anticipated for eachRevenue Maximization initiative.

4.4.7 Preparing and explaining a final report of actual savings generated and an

assessment of strategy for used for each initiative completed.

4.5 Contractual Requirements:

Proposers should be aware that if awarded the contract the following will berequirements.

4.5.1 Contractor must have experience providing Revenue Maximizationservices for governmental or business entities.

4.5.2 Contractor must acknowledge that the State does not use General

Purpose Revenues (GPR) to pay and complies with all federalrequirements for vendor contingency fees.

4.5.3 Contractor must agree to establish prior to performing work under anengagement letter authorized under this contract that nothing prohibitsusingportions of newly acquired funds to pay contingency fees andacknowledges that contingency fees will be paid within normal paymentterms after DHS receives the additional revenue.


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4.5.4 Contractor must acknowledge the State may require legislative approval tomake payment to the contractor under this contract and that requestingand receiving such approval may delay payment beyond the normal 30days.

4.5.5 Contractor must agree that no data, information or distribution lists relatedto this contract will be sold or otherwise distributed to a third party,including to any divisions owned by or affiliated with the contractor.

4.5.6 Contractor must agree to retain all records associated with theperformance of this contract for a period of not less than seven years fromthe end date of the contract or as required by federal laws, regulationsand/or guidelines.

4.5.7 Contractor must acknowledge and agree that the State will only awardcontracts to contractors who propose to be paid an administrative fee oron a contingency fee basis from new revenues claimed, drawn andretained by the State of Wisconsin. Unless specifically agreed to in the

written engagement letter, no expenses (travel reimbursement, time etc)will be paid directly or in addition to the vendor contingency oradministrative fees.

4.5.8 Contractor must agree that at any point during or after the term of thiscontract, if it is determined in any manner or for any reason that all or anypart of any increase in revenues received by the State as a result of workperformed by the vendor is not allowable under applicable federal law orpolicy, or if for any other reason payment must be returned to the federalprogram or other payer that the vendor shall assist in defending theappropriateness of claiming the revenue. Upon repayment by the State to

the federal program or other payer, the contractor must agree to promptlyreimburse the State all fees paid to vendor attributable to the non-allowable revenue/claims.

4.5.9 Contractor must assure that it is not simultaneously representingorganizations or initiatives that would be in conflict with components of thiscontract. Contractor agrees to disclose any possible conflicts of interestprior to proposing any applicable engagement letters.

4.5.10 Contractor must assure that they will comply with all applicable state andfederal privacy and confidentiality requirements.

4.5.11 Contractor will bear full responsibility for project development andexecution including providing staff with the necessary administrative andtechnical expertise, drafting provider communications and developing allnecessary federal and other documentation.


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5.0 TECHNICAL RESPONSE SECTION

Listed below are the technical proposal response requirements. The section(s) referencedwithin the response requirement provide detail concerning the required and/or desiredobjectives, work requirements, and standards to meet the needs of this program. This detailrepresents the minimum level of service requirements and objectives sought in thisprocurement. Many of the sections in this RFP are inter-related and may contain overlappinginformation. Proposers should incorporate the goals, objectives, work requirements andstandards stated throughout this RFP into their proposal.

Sections 5.1 through 5.4 are the specific areas of focus for the department relating to RevenueMaximization. Proposers are required to respond only to those sections in 5.1 through 5.4 inwhich they would like the opportunity to be evaluated for an opportunity to be eligible forplacement on Departments qualified list of vendors for these areas of Revenue Maximization.

Proposers must respond to Sections 5.5 with a descriptive narrative, which includesmethodology to the level of detail deemed appropriate by the proposer andappropriately labeled as referenced in Section 2.2 Proposal Organization and Format.

5.1 RM and Related Services Specific to Eligibility

5.1.1 Provide a detailed description of three past engagements, identifying Proposersexperience relevant to revenue maximization initiatives related to establishingand/or determining eligibility for human services programs. Includeengagements for which the proposer was the primary contractor or was asubcontractor and which took place during the last three (3) years. Thedescriptions must contain details on the purpose of the engagements, the typesof activities performed and the outcomes of the engagements. Proposers must

submit a response that describes their experience, demonstrated abilities, andtechnical expertise to improve the cost effectiveness of and/or maximize revenuewithin all processes related to eligibility. This response must include, but is notlimited to:

5.1.1.1 An overview of services the Proposer provided to government orbusiness entities for eligibility related revenue maximizationengagements.

5.1.1.2 A detailed description of each of the three eligibility initiativescompleted including a summary of the project plan, including

timeline, estimated and actual increased revenues/savings andan example of the fee structure developed for the RM eligibilityinitiatives. NOTE: the actual fees charged will have nobearing on the technical score, only the composition andstructure of how the fee structure was developed.

5.1.1.3 A detailed description of the strategies used to complete theinitiatives and the outcomes from implementing those strategies.

5.1.1.4 As/if appropriate, provide a sample of a Federal SPA andrelated communications or other similar documents requesting


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federal approvals the vendor was responsible for preparing aspart of the initiatives.

5.1.1.5 A detailed timeline of the work conducted for the initiatives ascompared to the originally planned timetable.

5.1.1.6 A summary comparison of the outcomes anticipated at the startof the revenue maximization project and the actual resultsachieved.

5.1.2 Provide at least three (3) references from each of the engagements listed above.

5.1.2.1 Include points of contact (name, address, fax number, emailaddress, and telephone number).

5.1.2.2 The references must be knowledgeable enough to certify theproposer has experience developing and successfullyimplementing RM Eligibility Initiatives.

5.1.2.3 The references must be able to provide and/or verify informationon overall work performed, revenues received and/or savingsaccrued quality, timeliness, staff competence, cooperation, andcommunication with the contracting agency, reputation andsensitivity.

5.1.2.4 Referenced organizations may be contacted by the State todetermine the extent and quality of work performed andpersonnel assigned to the project.

5.1.3 Provide a detailed description of any deferrals or disallowances issued by federalgrantor agencies within the past three years associated with any eligibilityrevenue maximization initiatives you have completed. Describe the nature of thedeferral/disallowance, actions you took with or on behalf of the government entityto whom the deferral/disallowance was issued, your role in developing andimplementing related corrective action plans and the final outcome of the effortsto refute the deferral/disallowance.

5.1.4 Provide detailed information of any instances during the past three years in whicha contract or engagement letter between you and a government entity wasterminated for cause.

5.1.5 Specify how the professional personnel performing work related to eligibilityunder this contract will interact organizationally; include the name, contactinformation and title of the person who will provide the program direction for RMactivities specific to Eligibility Initiatives. Proposing vendors should respond withan organizational chart for eligibility initiatives under this contract which identifieskey vendor staff, including staff title, and role. Anticipated key personnelproposed by the vendor shall collectively and individually have at least thefollowing experience, skills and education, as supported by theirresumes/Curriculum:


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5.1.5.1 At least one individual must have at least five (5) years of project

management experience, direct access to corporate expertise withthis experience or professional certification in project management.

5.1.5.2 At least one individual must have at least five (5) years experienceor direct access to corporate expertise in business analysis and

planning, including organizational and business plan development.5.1.5.3 At least one individual must have at least five (5) years experience

or direct access to corporate expertise in Revenue Maximizationinitiatives related to eligibility for human services programs.

5.1.5.4 At least one individual must have at least three (3) years overallexperience or direct access to corporate expertise in ProgramEfficiency and/or Revenue Maximization planning and design.

Note: One proposed person could satisfy more than one of the aboverequirements, but any one individual requirement may not be satisfied by totalingthe experience of two or more persons proposed by the vendor.

5.1.6 Provide resumes describing the educational and work experiences for each ofthe key staff who would be assigned to manage and direct work under EligibilityInitiatives.

5.1.7 Describe proposers capacity and professional expertise to continue to undertakeRM eligibility initiatives specific to the requirements in Section 4.1.

5.2 RM and Related Services Specific to Benefit Initiatives :

5.2.1 Provide a detailed description of three past engagements, identifying Proposers

experiences relevant to revenue maximization initiatives related to administeringbenefits under human services programs. Include engagements for which theproposer was the primary contractor or a subcontractor and which took placeduring the last three (3) years. The descriptions must contain details on thepurpose of the engagements, the types of activities performed and the outcomesof the engagements. Proposers must submit a response that describes theirexperience, demonstrated abilities, and technical expertise to improve the costeffectiveness of and/or maximize revenues within any and all processes relatedto administering benefits under human services programs. This response mustinclude, but is not limited to:

5.2.1.1 An overview of services the Proposer provided to governmentor business entities for benefits related revenue maximizationengagements.

5.2.1.2 A detailed description of each of the three benefit initiativescompleted including a summary of the project plan includingtimeline, estimated and actual increased revenues/savings, anexample of the fee structure developed, and revenuesgenerated for the RM Benefit Initiatives. NOTE: the actual feescharged will have no bearing on the technical score, only


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the composition and structure of how the fee structure wasdeveloped

5.2.1.3 A detailed description of the strategies used to complete theinitiatives and the outcomes from implementing those strategies.

5.2.1.4 As/if appropriate, provide a sample of a Federal State PlanAmendment and related communications or other similardocuments requesting federal approvals the vendor wasresponsible for preparing as part of the initiatives.


5.2.1.6 A summary comparison of the outcomes anticipated at the startof the revenue maximization project and the actual resultsachieved.

5.2.2 Provide at least three (3) references from each of the engagements listedabove.


5.2.2.2 The references must be knowledgeable enough to certify theproposer has experience developing and successfullyimplementing RM Benefit Initiatives.

5.2.2.3 The references must be able to provide and/or verify information

on overall work performed, revenues received and/or savingsaccrued quality, timeliness, staff competence, cooperation, andcommunication with the contracting agency, reputation andsensitivity.


5.2.3 Provide a detailed description of any deferrals or disallowances issued by federalgrantor agencies within the past three years associated with any benefits related

revenue maximization initiatives you have completed. Describe the nature of thedeferral/disallowance, actions you took with or on behalf of the government entityto whom the deferral/disallowance was issued, your role in developing andimplementing related corrective action plans and the final outcome of the effortsto refute the deferral/disallowance.

5.2.4 Provide detailed information of any instances in which a contract or engagementletter between you and a government entity was terminated for cause.


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5.2.5 Specify how the professional personnel performing work under the contractrelated to administering benefits will interact organizationally; include the name,contact information and title of the person who will provide the program directionfor RM activities specific to Benefit Initiatives. Proposing vendors should respondwith an organizational chart for Benefit Initiatives under this contract whichidentifies key vendor staff, including staff title, and role. Anticipated keypersonnel proposed by the vendor shall collectively and individually have at leastthe following experience, skills and education, as supported by theirresumes/Curriculum Vitaes:

5.2.5.1 At least one individual must have at least five (5) years ofproject management experience, direct access to corporateexpertise with this experience or professional certification inproject management.

5.2.5.2 At least one individual must have at least five (5) yearsexperience or direct access to corporate expertise in business

analysis and planning, including organizational and businessplan development.

5.2.5.3 At least one individual must have at least five (5) yearsexperience or direct access to corporate expertise in RevenueMaximization initiatives related to administration of benefits forhuman services programs.



5.2.6 Provide resumes describing the educational and work experiences for each ofthe key staff who would be assigned to manage and direct work under BenefitInitiatives.

5.2.7 Describe proposers capacity and professional expertise to continue to undertakeRM Benefit Initiatives specific to the requirements in Section 4.2.

5.3 RM and related Services Specific to Administrative Services

5.3.1 Provide a detailed description of three past engagements, identifying Proposersexperiences relevant to revenue maximization initiatives related to administeringhuman services programs. Include engagements for which the proposer was theprimary contractor or a subcontractor and which took place during the last three(3) years. The descriptions must contain details on the purpose of theengagements, the types of activities performed and the outcomes of theengagements. Proposers must submit a response that describes theirexperience, demonstrated abilities, and technical expertise to improve the costeffectiveness of and/or maximize revenues within any and all processes related


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to administering human services programs. This response must include, but isnot limited to:

5.3.1.1 An overview of services the Proposer provided to governmentor business entities for human services program administrationrelated revenue maximization engagements.

5.3.1.2 A detailed description of each of the three human servicesprogram administration initiatives completed including asummary of the project plan including timeline, estimated andactual increased revenues/savings and an example of the feestructure developed and revenues generated for the RM HumanServices Program Administration Initiatives. NOTE: the actualfees charged will have no bearing on the technical score,only the composition and structure of how the fee structurewas developed

5.3.1.3 A detailed description of the strategies used to complete the

initiatives and the outcomes from implementing those strategies.

5.3.1.4 As/if appropriate, provide a sample of a Federal State PlanAmendment and related communications or other similardocuments requesting federal approvals the vendor wasresponsible for preparing as part of the initiatives.


5.3.1.6 A summary comparison of the outcomes anticipated at the start

of the revenue maximization project and the actual resultsachieved.

5.3.2 Provide at least three (3) references from each of the engagements listedabove.


5.3.2.2 The references must be knowledgeable enough to certify theproposer has experience developing and successfully

implementing RM Human Services Program AdministrationInitiatives.

5.3.2.3 The references must be able to provide and/or verify informationon overall performed, revenues received and/or savingsaccrued quality, timeliness, staff competence, cooperation, andcommunication with the contracting agency, reputation andsensitivity.


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5.3.3 Provide a detailed description of any deferrals or disallowances issued by federalgrantor agencies within the past three years associated with any human servicesprogram administration related revenue maximization initiatives you havecompleted. Describe the nature of the deferral/disallowance, actions you tookwith or on behalf of the government entity to whom the deferral/disallowance wasissued, your role in developing and implementing related corrective action plansand the final outcome of the efforts to refute the deferral/disallowance.

5.3.4 Provide detailed information of any instances in which a contract or engagementletter between you and a government entity was terminated for cause.

5.3.5 Specify how the professional personnel performing work under the contractrelated to administering human services programs will interact organizationally;include the name, contact information and title of the person who will provide the

program direction for RM activities specific to Human Services ProgramAdministration Initiatives. Proposing vendors should respond with anorganizational chart for Human Services Program Administration Initiatives underthis contract which identifies key vendor staff, including staff title, and role.Anticipated key personnel proposed by the vendor shall collectively andindividually have at least the following experience, skills and education, assupported by their resumes/Curriculum Vitaes:

5.3.5.1 At least one individual must have at least five (5) years of

project management experience, direct access to corporateexpertise with this experience or professional certification inproject management.

5.3.5.2 At least one individual must have at least five (5) yearsexperience or direct access to corporate expertise in businessanalysis and planning, including organizational and businessplan development.

5.3.5.3 At least one individual must have at least five (5) yearsexperience or direct access to corporate expertise in RevenueMaximization initiatives related to administration of benefits forhuman services programs.



5.3.6 Provide resumes describing the educational and work experiences for each ofthe key staff who would be assigned to manage and direct work under HumanServices Program Administration Initiatives.


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WI Dept of Health Services Request for Proposals, Revenue Maximization, May 2012

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Transcript of WI Dept of Health Services Request for Proposals, Revenue Maximization, May 2012