City of Brockton / Brockton Public Schools Contract / Bid Number: Name of Bid:

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1 Proposal (RFP) Interest Form Proposal Form #1 Instructions: If your firm/company is interested in responding to this proposal, then Proposal Form #1 MUST be submitted to the Office of Financial Services immediately following download. This form is crucial in providing pertinent company information for proposer s list tracking and distribution of any potential addendum. Awarding Authority: City of Brockton / Brockton Public Schools Contract / Bid Number: Name of Bid: FY2015 MEDICAID REVENUE MAXIMIZATION INITIATIVE AND DATA MANAGEMENT SYSTEM Fax this PROPOSAL Interest #1 Form to: Brockton Public Schools / Office of Financial Services Fax: By submitting this PROPOSAL Interest Form the below identified firm is expressing its interest in the above-referenced public proposing project and is requesting that it be added to the list of firms that will receive any addenda to the PROPOSAL that might occur. The Awarding Authority assumes no responsibility for a firm s failure to receive any addenda or other correspondence related to this PROPOSAL due to the firm s failure to submit a PROPOSAL Interest Form as directed above or for any other reason. Company Name: Company Address: City/Town, State & Zip: Company Telephone #: Company Fax #: Company Contact Person/Title: Contact Person Address: Date Submitted: By: (Signature of Authorized Representative)

2 March 3, 2014 Gentlemen: Enclosed you will find specifications for the FY2015 MEDICAID REVENUE MAXIMIZATION INITIATIVE AND DATA MANAGEMENT SYSTEM in order that you may offer a proposal if you are interested. Proposal envelopes should be marked, FY2015 MEDICAID REVENUE MAXIMIZATION INITIATIVE AND DATA MANAGEMENT SYSTEM FOR BROCKTON PUBLIC SCHOOLS, BROCKTON, MASSACHUSETTS. All proposals must be submitted in two (2) separate, sealed envelopes, bearing on the outside the name of the offeror, the address, and the name of the proposal. The first envelope labeled SEALED PROPOSAL FORMS will include all pages marked PROPOSAL FORM ; the second envelope labeled SEALED COST PROPOSAL. The sealed proposal forms will be opened at the Crosby Administration Building, 43 Crescent Street, Brockton, Massachusetts, on MONDAY, MARCH 17, 2014 AT 11:15 a.m. E.D.S.T. PLEASE BE ADVISED THAT THE AWARD OF CONTRACTS BY THE BROCKTON SCHOOL COMMITTEE FOR ANY ITEM(S) LISTED HEREIN IS CONTINGENT UPON APPROPRIATE FUNDING BY THE BROCKTON CITY COUNCIL FOR THE SCHOOL DEPARTMENT S FY2015 BUDGET. Sincerely, Aldo E. Petronio Chief Budget Officer AEP:mjb

3 SCHOOL PROPOSAL FY2015 MEDICAID REVENUE MAXIMIZATION INITIATIVE AND DATA MANAGEMENT SYSTEM FOR THE BROCKTON PUBLIC SCHOOLS BROCKTON, MASSACHUSETTS CONTRACT # Honorable Mayor Bill Carpenter City of Brockton Brockton, Massachusetts Kathleen A. Smith, JD Superintend ent of Schools Brockton, Massachusetts ADVERTISING DATES: RFP RECEIPT DATE: THE ENTERPRISE MONDAY, MARCH 17, 2014 MONDAY, MARCH 3, :15 a.m., E.D.S.T. Crosby Administration Building GOODS AND SERVICES 43 Crescent Street MONDAY, MARCH 3, 2014 Brockton, Massachusetts 02301

4 BROCKTON PUBLIC SCHOOLS BROCKTON, MASSACHUSETTS Aldo E. Petronio Office of Financial Services 43 Crescent Street Brockton, Massachusetts PROPOSAL Sealed proposals for FY2015 MEDICAID REVENUE MAXIMIZATION INITIATIVE AND DATA MANAGEMENT SYSTEM will be received by the Office of Financial Services, 43 Crescent Street, Brockton, Massachusetts, MONDAY, MARCH 17, 2014 at 11:15 a.m. All proposal procedures shall be in strict accordance with Chapter 30B of the General Laws Section 1 through 25, inclusive. The awarding authority reserves the right to reject any or all proposals and to waive any informality in the bidding if it be in the public interest to do so, provided such rejection of waiver be in conformance with Sections 1 to 25, inclusive of Chapter 30B of the General Laws as adopted. INFORMATION FOR OFFERORS 1. Specifications are available after 1:00 p.m. on MONDAY, MARCH 3, Proposal forms are available on our website. The hyperlink is Should you require a paper copy you may contact our office. 3. Proposals will be received at the Crosby Administration Building, Office of Financial Services, 43 Crescent Street, Brockton, Massachusetts, by MONDAY, MARCH 17, 2014, 11:15 a.m., E.D.S.T. 4. All proposals received after this date and time will be rejected. 5. All successful offerors of corporations which are located outside the confines of the Commonwealth of Massachusetts must be registered with the Secretary of the Commonwealth of Massachusetts as a Foreign Corporation to do business in the Commonwealth of Massachusetts prior to the awarding of the bid. 6. Double check all prices submitted. Prices that are submitted by a vendor in error will be considered as a firm proposal by the School Department. "Adjustments" may not be made after the RFP receipt to correct such errors. Failure to honor proposal prices - even the error may place the offeror in jeopardy for future proposals. 7. The contract, or any part of it, may not be transferred or assigned to another company or 1

5 individual without the consent of the School Department. a. These proposals shall contain firm prices and shall not be withdrawn for a period of fortyfive (45) days subsequent to the opening thereof, without the consent of the School Department. b. No proposals will be acceptable unless properly made out on the enclosed proposal forms, and signed by the offeror. All proposals must be legible, either typewritten or in ink. Pages with PROPOSAL FORM indicated at the bottom must be returned and submitted in a sealed envelope labeled "SEALED PROPOSAL FORMS". Pages with COST PROPOSAL FORM indicated at the bottom must be returned and submitted in a sealed envelope labeled "SEALED COST PROPOSAL". 8. Action on the award of proposals will be taken within approximately thirty (30) days after the opening of the proposals. 9. Contracts will be in force from July 1, 2014 until June 30, Said contract will be cancelled if funds are not appropriated or otherwise made available to support continuation of performances during any fiscal year. 10. The School Committee of the City of Brockton may make such investigation as is deemed necessary to determine the ability of the offeror to perform the work, and the offeror shall furnish to the School Committee of the City of Brockton all such information and data for this purpose as the School Committee may request. The School Committee reserves the right to reject any proposal if the evidence submitted by the offeror or investigation of such offeror fails to satisfy the School Committee that such offeror is properly qualified to carry out the obligation of the contract and complete the work contemplated therein. 11. To be considered as a responsive offeror, offerors must submit a proposal which conforms in all respects to the request for proposals. Proposals must be based on all function, standard, precision and quality as specified. Any and all omissions must be clearly stated on the attached deviation sheet; moreover, any substitutions or deviations must be enumerated and detailed with the amount to be deducted, if the omission, substitution or deviation is approved. 12. The ability of the offeror(s) to furnish a FY2015 MEDICAID REVENUE MAXIMIZATION INITIATIVE AND DATA MANAGEMENT SYSTEM for the Brockton Public Schools promptly and professionally as required by the Brockton Public Schools shall be heavily weighed. Past record of failure to comply with this aspect of the business procedure will lead to rejection of the offeror as not responsible to the needs of the City of Brockton. A responsible offeror has the capability to perform the contract requirements and the integrity and reliability which assures good faith performance. 13. Allow adequate time for mail delivery of proposals and for delivery by overnight express services. 2

6 14. PAYMENTS: The successful offeror(s) must comply with the following billing procedures: Invoices shall be submitted in triplicate (one copy shall be marked ("ORIGINAL") unless otherwise specified and shall contain the following information: Contract or service number, item number, contract description of supplies or services sizes, quantities, unit prices and extended totals. Unless otherwise specified, payment will be made on partial deliveries accepted by the City of Brockton when the amount due on such deliveries so warrants. Three (3) legible copies of invoices must be submitted to: Brockton Public Schools Accounts Payable Office Attn.: Ms. Barbara Hughes 43 Crescent Street Brockton, MA Questions regarding any item should be directed to: Mrs. Laurie Mason 43 Crescent Street Brockton, MA Telephone: (508) The Brockton School Department reserves the absolute right to choose any offeror for the FY2015 MEDICAID REVENUE MAXIMIZATION INITIATIVE AND DATA MANAGEMENT SYSTEM FOR BROCKTON PUBLIC SCHOOLS which best meets its needs based on the degree of quality, workmanship, results of inspections and tests, and suitability for the particular purpose. 16. Prices not holding for the contract duration should be noted in writing in the proposal. 17. Pursuant to Section 6 of Chapter 30B of the Massachusetts General Laws, the chief procurement officer of the Brockton Public Schools shall not solicit competitive sealed proposals unless he has determined in writing that selection of the most advantageous offer requires comparative judgments of factors in addition to price, specifying the reasons for his determination. Competitive sealed proposals shall be solicited, advertised, received, evaluated, and awarded as per Section 6 of Chapter 30B, inclusive, of the Massachusetts General Laws. 18. The City of Brockton is an Affirmative Action/Equal Opportunity/Title IX employer. 3

7 VENDOR TAX CERTIFICATE I certify, under the pains and penalties of perjury, that to the best of my knowledge and belief, I have filed all state tax returns and paid all state taxes required under the law. For use by CORPORATIONS ONLY: PROPER CORPORATE NAME SIGNATURE OF AUTHORIZED CORPORATE OFFICER FEDERAL INDENTIFICATION NUMBER (FEIN) For use by INDIVIDUALS OR COMPANIES OTHER THAN CORPORATIONS ONLY: * SIGNATURE OF INDIVIDUAL ** SOCIAL SECURITY NUMBER *Approval of contract or other agreement will not be granted unless this certification clause is signed by applicant. **Your social security number will be furnished to the Massachusetts Department of Revenue to determine whether you have met tax filing/payment obligations. CERTIFICATE OF CORPORATE VOTE I, ; clerk/officer of hereby notify that at a meeting of the Board of Directors/Officials of said corporation/company, held on the following vote was passed: Vote to authorizing to sign in behalf of the corporation/company with the City of Brockton for. Signature of Clerk/Officer * PLEASE ATTACH COPY OF OFFICIAL CERTIFICATE OF CORPORATE VOTE. PROPOSAL FORM (Must be submitted) 4

8 AFFIDAVIT OF CLERK OF CORPORATION VENDOR (To be signed and completed by Clerk) I,, certify as follows: (Print full name of Clerk) 1. I am the Clerk of (print exact name of corporation) which is duly organized and incorporated under the laws of the Commonwealth of Massachusetts (or State of ) and is/is not (circle one) duly registered to do business in the Commonwealth of Massachusetts with a principal place of business at. 2. That the names, residential addresses and title officers of the above named corporation are as follows: President Address Vice President Address Treasurer Address Resident/Registered Agent Address 3. That the above named corporation was incorporated on. 4. The federal tax identification number of said corporation is. 5. That the above named corporation is in good standing with the Secretary of the Commonwealth of Massachusetts or the State of (if incorporated under the laws of a foreign State) and has filed all federal and state tax returns and paid all federal, state and/or local taxes required under law. 6. is authorized to sign contract/agreements on behalf of pursuant to a vote of the Board of Directors/Officers on. 7. I, on behalf of the within corporation, do hereby acknowledge that by this contract, this corporation is transacting business within the Commonwealth of Massachusetts as defined by M.G.L. Chapter 223 A, Section 1, et seq. And is subject to the jurisdiction of its courts. (Pertaining to Non- Massachusetts Corporations Only.) SIGNED under the pains and penalties of perjury this day of, 20. Signature of Clerk of Corporation PROPOSAL FORM (Must be submitted) 5

9 TO BE COMPLETED BY ALL VENDORS: VENDOR REGISTRATION FORM TYPED/PRINTED NAME AND TITLE: SIGNATURE: DATE: PROPER LEGAL NAME OF BUSINESS ENTITY: FEIN or SOCIAL SECURITY NUMBER if FEIN is N/A: BUSINESS ADDRESS, CITY, STATE, ZIP: TELEPHONE NO: FAX NO: IF CORPORATION: 1. GIVE YOUR CORRECT CORPORATE NAME: 2. STATE AND DATE OF INCORPORATION: 3. IF FOREIGN CORPORATION, GIVE MASSACHUSETTS REGISTRATION DATE: IF FOREIGN BUSINESS ENTITY TRANSACTING BUSINESS IN MA, GIVE NAME/ADDRESS OF RESIDENT/REGISTERED AGENT IN MA (REQUIRED): IF COMPANY, GIVE the OWNER S NAME AND TITLE: IF PARTNERSHIP, GIVE NAMES AND ADDRESSES OF PARTNERS: IF TRUST OR LEGAL ENTITY, GIVE NAMES AND ADDRESSES OF TRUST OR LEGAL ENTITY: MINORITY/WOMEN BUSINESS CLASSIFICATION STATEMENT 1. Our firm is principally (more than 50%) minority owned. YES NO 2. Our firm is principally (more than 50%0 woman owned. YES NO 3. Our firm is registered with S.O.M.B.A. (State Office of Minority & Business Assistance) YES NO SOMWBA CERTIFICATION CATEGORY: / MBE WBE PROPOSAL FORM (Must be submitted) 6

10 Attestation Clause Under Chapter 233, Section 35 of the Acts of 1983, political subdivisions and agencies of the Commonwealth must annually furnish to the Commissioner of Revenue a list of all persons who have provided goods, services or real estate space in the aggregate of five thousand dollars ($5,000.00) or more. Chapter 233 of the Acts of 1983, Sections 35 and 36 require that each provider or vendor of goods and services to any municipal agency must attest that it/he is in compliance of all laws relating to taxes. The Attestation must occur at the time of issuing, renewing, or extending a license, contract or agreement. Any person/company failing to execute this Attestation Clause shall not be allowed to obtain, renew or extend a license, contract or agreement. Each successful proposer shall certify that he is in compliance with Chapter 233 by providing a Social Security Number or Federal Identification Number when a contract is issued. VENDOR/COMPANY: AUTHORIZED SIGNATURE: TYPED/PRINTED NAME AND TITLE: Certificate of Non-Collusion and Certificate of Bona Fide Proposal As per Chapter 30B, Section 10, any person submitting a proposal for the procurement or disposal of supplies or services to any governmental body shall certify in writing, on the proposal, as follows: The undersigned certifies under the penalty of perjury that this proposal has been made and submitted in good faith and without collusion or fraud with any other person. As used in this certification, the word person shall mean any natural person, business partnership, corporation, union, committee, club or other organization, entity, or group of individuals. VENDOR/COMPANY: AUTHORIZED SIGNATURE: Assurance of Non-Discrimination Compliance Vendor does not subject employees or applicants for employment by this firm to discrimination on the basis of race, color, national origin, handicap, age or sex, in any of the following areas: 1. Recruitment, hiring, upgrading, promotion, whether for full-time employment, consideration for demotion, transfer, layoff, or rehiring. 2. Rates of pay or any other form of compensation and changes in compensation. 3. Job assignments and seniority status. 4. Granting and returning from leaves of absence, leave for pregnancy, or any other leave. 5. Fringe benefits available by virtue of employment, whether or not administered by the recipient. 6. Selection and financial support for training, including apprenticeship, professional meetings, conferences and other related activities, selection for tuition assistance, and selection for sabbaticals and leaves of absence to pursue training. 7. Employer-sponsored activities, including social or recreational programs. 8. Any other term, condition, or privilege of employment. VENDOR/PROPOSER: AUTHORIZED SIGNATURE/TITLE/DATE: ADDRESS AND TELEPHONE: PROPOSAL FORM (Must be submitted) 7

11 Certificate of Insurance (Service Contracts Only*) As successful proposer on this Contract, you must supply the City of Brockton with a properly endorsed CERTIFICATE OF INSURANCE. Both the City of Brockton and the Vendor shall be named as coinsured/additional insured and the City shall be named as certificate holder, and certificates of insurance shall be furnished to both parties. Reporting of accidents and claims shall be done by the Vendor. This Certificate MUST accompany the Contract. Unless otherwise provided for by the Contract, Vendor shall meet the following insurance requirements: WORKERS COMPENSATION: The Vendor, before commencing performance of the work required to be done under the Contract, shall provide for the payment of compensation, provided by the General Laws (ter. Ed.) Chapter 152 as amended to all persons to be employed by him/her in connection with said performance and shall continue in full force throughout the period of this Contract. PUBLIC LIABILITY: Within fifteen (15) days after the award of this Contract the Vendor shall, at his own expense, procure and maintain insurance for Public Liability in the minimum amount of $500,000/$1,000,000 and Property Damage Liability in the minimum amount of $50,000/$100,000. The policies shall contain a provision worded as follows: The Insurance Company waives any right to subrogation against the City of Brockton which may arise by reason on any payments under this policy. The policy/policies must contain on the face a notation that it/they cannot be cancelled without at least thirty (30) days notice in writing to the City as owner. Furthermore, the certificates of all policies shall provide for notice of cancellation of the Contracting officer and the certificates shall indicate that the above provisions have been included. *DESIGN/CONSULTING SERVICES, PLEASE PROVIDE PROOF OF PROFESSIONAL LIABILITY INSURANCE. AUTHORIZED SIGNATURE: Indemnification and Release The Vendor shall indemnify and hold the City of Brockton harmless from any and all acts & omissions arising out of this contract by the Vendor, its agents, employees or representatives. Furthermore the term Vendor shall include the aforementioned wherever stated in the Contract. Further, the Vendor shall indemnify and hold harmless the City of Brockton against any/all suits, claims, actions, costs or damages to which the City may be subject to by reason of damages to the property or person of anyone, arising or resulting from fault, negligence, or wrongful omissions by the Vendor. Said indemnification and hold harmless should apply in any event that a claim is brought against the City of Brockton for said acts caused by others. The Vendor, their agent(s), representatives or employees shall release and hold the City of Brockton harmless for any injury to themselves, corporate officers, agents, representatives or employees in connection with the performance or omission of this Contract or any related sub-contract thereof. AUTHORIZED SIGNATURE: PROPOSAL FORM (Must be submitted) 8

12 DEVIATION SHEET All deviations and/or substitutions from the original specified items (or equal) must be noted in writing on the Deviation Sheet. Additional pages may be used if necessary. These items shall be approved by the lead department for compatibility, workmanship, and functionality before award of contract. PLEASE LIST BELOW: COMPANY: TYPED NAME: SIGNATURE: TITLE: PROPOSAL FORM (Must be submitted) 9

13 VENDOR WORK HISTORY A. The undersigned proposes to supply:fy2015 MEDICAID REVENUE MAXIMIZATION INITIATIVE AND DATA MANAGEMENT SYSTEM. B. The undersigned offers the following information as evidence of his qualifications to perform the work as bid upon, according to all the requirements of the specifications. 1. Have been in business under present business name for years. 2. Are you fully licensed to do business under this contract? 3. Do you comply with all ordinances and regulations mandated by M.G.L. and the community in which you are located? 4. Ever fail to complete any work awarded? 5. Have you been involved in litigation in the past five (5) years? 6. List at least three (3) state, local or private companies and/or organizations which you have served recently of similar character as required for the above-mentioned. LOCATION PHONE # DATE DESCRIPTION OF WORK C. Proposers shall indicate firm date of delivery on receipt of contract and subsequent purchase order form the City of Brockton. DELIVERY DATE: COMPANY: TYPED NAME: SIGNATURE: TITLE: D. Proposers shall note that this proposal reflects all changes in addendum/amendment numbers: PROPOSAL FORM (Must be submitted) 10

14 FY2015 MEDICAID REVENUE MAXIMIZATION INITIATIVE AND DATA MANAGEMENT SYSTEM FOR BROCKTON PUBLIC SCHOOLS SPECIFICATIONS The Brockton Public Schools is requesting proposals for the FY2015 MEDICAID REVENUE MAXIMIZATION INITIATIVE AND DATA MANAGEMENT SYSTEM FOR BROCKTON PUBLIC SCHOOLS. A. GENERAL INFORMATION The Brockton Public Schools, through it s Finance Office, wishes to obtain the services of a qualified contractor to review the current system and to recover retroactive and prospective reimbursements from third party payers, particularly the Federal Medicaid and private insurance companies, for medical services which it has provided to school children enrolled in the school system. The qualified contractor must also possess the ability to interface the individual educational program with Infinite Campus, the student information management system into a central database. This proposal is predicated on revenue recovery above and beyond the system already in place. The Brockton Public Schools is eligible to receive Medicaid reimbursement under the Medicaid Catastrophic Coverage Act of The School Department is approved as an official Medicaid provider. The contractor, selected under this RFP, shall be responsible for filing all Medicaid reimbursement applications for the period beginning upon the date of the award through June 30, 2014, plus any claim for previous years that are still pending. Source data for the applications are found in the manual records maintained by the Special Education Office of the Brockton School Department located in the Crosby Administration Building, 43 Crescent Street, Brockton, MA Brockton Public Schools enrolls approximately 2,269 students in programs who have been identified with a disability. The estimated number of special needs students enrolled is listed as follows: DOE Code 032 Placement Ages 3-5 Code or more hrs/wk in the early childhood program and IEP services provided in inclusive setting 50% of time or less. 51 Code or more hrs/wk in the early childhood program and IEP services provided in inclusive setting majority of the time (greater than 50%). 59 Code 32 Less than10 hrs/wk in the early childhood program and IEP services provided in inclusive setting 50% of time or less. 10 Code 34 Less than10 hrs/wk in the early childhood program and IEP services 11

15 provided in inclusive setting majority of the time (greater than 50%). 10 Code 36 Substantially Separate Class (previously 40). 87 Code 46 Home (previously 70). 1 Code 48 Service provider location (private clinician s offices, clinician s office in school building, hospital facilities). 30 Total 248 DOE Code 034 Placement Ages 6-21 Code 10 Full Inclusion special education services outside the general education classroom less than 21% of the time. 1,278 Code 20 Partial Inclusion special education services outside the general education classroom 21% to 60% of the time. 113 Code 40 Substantially Separate Classroom special education services outside the general education classroom more than 60% of the time. 521 Code 41 Public Separate Day School 50 Code 50 Private Separate Day School 45 Code 60 Residential School 8 Code 70 Homebound / Hospital 3 Code 90 Residential Institutional Facilities 3 Total 2,021 DOE Codes 032 Placement Ages 3-5 & 034 Placement Ages 6-21 Total 2,269 The total enrollment in the Brockton Public Schools was 17,311 in grades Pre-K through 12 as of October 1, Of these 2,269 special education students, currently 66.8% were eligible under the current Medicaid guidelines to receive services specialized instruction according to Federal and State regulations. An amount totaling approximately $2,121,660 was collected in FY13 from this program. B. SCOPE OF SERVICES The Brockton Public Schools wants to employ a qualified contractor/consultant to serve as an agent to the School Department to recover both retroactive and prospective Medicaid reimbursements. The contractor must provide a full implemented application and collection process, through a performance-based contract that will not add to the workload of the current School Department staff. The approved contractor will be responsible for quarterly reports and to develop and implement a billing and collection process within 60 days of the contract award. The contractor will remain responsible for any/all contract conditions through June 30, The full scope of this contract includes regular reporting to the Superintendent of Schools, the Executive Directors of Financial Services and Pupil Personnel and the Director of Special Education for the Brockton Public Schools, development and ongoing operation of a documented comprehensive Medicaid reimbursement system that augments what currently is in place and requires no additional resources on the part of the Brockton Public Schools. The services provided by the Brockton Public Schools which are considered to be reimbursable shall include, but not be limited to, the following: 12

16 Early & periodic screening & diagnostic & treatment (EPSDT) and family planning services and supplies. Physicians Services. Medical & other remedial care provided by licensed practitioners. Clinic-based services. Physical therapy, occupational therapy, and services for individuals with speech, hearing, & language disorders. Prescriptions, dentures, prosthetic devices & eyeglasses. Diagnostic screening, preventative, and rehabilitative services. Transportation for the recipient by ambulance, taxicab, common carrier or other appropriate means. Special Education services provided by therapists, aides, nurses, evaluation team members, social workers and psychologists. Administration of the above listed services. The Brockton Public Schools will review proposals from qualified vendors to provide consulting services to secure maximum reimbursement from Medicaid and other third party payers to services provided to children enrolled in the school system. These consulting services must include, at a minimum the following: 1. Develop a work plan detailing the services to be provided to obtain payments from 3rd party payers on a retroactive and prospective basis augmenting and/or supplementing what is being done internally at the Brockton School Department. In addition the responsive proposal must specify all process and system implementation activities and deadlines for billing and collecting reimbursements from Medicaid and other third party payers upon 60 days after the date of contract award. Also, the proposer must exhibit a knowledge of current Medicaid rates, the information required to bill for those rates, and the steps necessary to apply for Medicaid billing. Additionally, the proposal must include a plan for further enhancement for Medicaid revenue maximization activities, for areas of potential new reimbursement, and steps necessary using existing personnel required to obtain revenue from those areas. 2. Provide a module to document health-related services which fully integrates the individualized educational program with our student information management system. 3. Provide technical assistance, where necessary to maintain full compliance with federal and state Medicaid regulations and any other applicable laws regulations and/or provisions. 4. Guarantee full compliance with all Massachusetts Medicaid requirements in developing and implementing new and/or supplemental billing and collection operations for the City. 5. Identify and compile a comprehensive list of reimbursement-eligible services to school children for which claims will be submitted to 3rd party payers on both a retroactive and prospective basis in conjunction with School Dept. personnel. 13

17 6. Recommend changes in the current Unit of Service data collection process currently used to support increased 3rd party billing and collections. 7. Review the current billing and account receivable management system in order to augment and/or recommend changes where deemed necessary in order to improve the ongoing operation for claiming and tracking retroactive and prospective reimbursement from 3rd party payers. 8. Implement a data collection process and billing collections system within 60 days of the contract award. 9. Operate a data collection process and billing & collections system through June 30, The Brockton Public Schools wants to employ a qualified contractor/consultant to serve as an agent to the School Department to provide an integrated central database system that can manage all individualized educational program information and integration with the student information management system as well as reporting compliance with Massachusetts Special Education laws. A flexible Internet-based solution for the development and management of IEP information and reports that will improve compliance and accountability; provide instant access to information and provide administrators with a full set of management and compliance reports. These consulting services must include, at a minimum the following: 1. Proposed Customization: Lists and data fields; User access; IEP/documents/letters; Reports. 2. Proposed Reporting Analysis: Custom report wizard; December reports; Exit reports; management reports; Compliance reports; Automatic report generation. 3. Proposed Support: On-site teacher/administrator training; Built-in support; Toll-free hotline. 4. Proposed Compliance: Visual compliance; IEP deadline tracking and notification; Edit checking; Correspondence tracking. 5. Proposed Technology: Import existing data; Interface with student information system; Increased continuity and disaster recovery; Unlimited user capacity; Increased security capabilities; Simplified and shortened implementation. C. QUALIFICATIONS In order to provide verification of responses through the Minimum Evaluation Criteria selection of this request for proposal, offerors must submit written information which details their general background, experience and organization s qualification. Responses should document that: 14

18 1. Proposer has been in business (in some capacity) regarding third party reimbursement/maximization services for at least 8 years. 2. Proposer has had successful experiences developing third party billing, collection and management reporting systems for health services in at least 5 localities school systems, or states within the last 8 years. Successful means having clients who have received cash payments from third party payers, particularly Medicaid and private insurance carriers. 3. Experience and references. The proposer must demonstrate its ability to manage project responsibilities as evidenced by previous experience with similar projects during the past 8 years, by providing references as indicated below. a. The name address, and telephone number of each client as previously referenced. b. A description of the work done under each contract. c. The name and telephone number of the person the City may contact as a reference. d. The contract amount. e. The volume of work performed. f. Date(s) of contract duration. 4. Project staffing The successful proposer s Project Manager and their staff must display the ability to carry out the contract requirements. Experience with Massachusetts Medicaid and billing requirements is necessary. A staffing plan, including resumes, must be submitted detailing the background and number of staff to be assigned to this project. The Brockton Public Schools will also evaluate the number of full-time equivalents proposed. (Ref: Evaluative Criteria) D. RESPONSIBILITY OF THE BROCKTON PUBLIC SCHOOLS 1. Assign a School Department member to work with the contractor for the agreement s duration. 2. Respond to all questions asked by the contractor related to this project. 3. Review work plans, billing systems, etc. as required by this bid, the contract and/or the designated municipal official. E. CONTRACTOR S RESPONSIBILITY 1. Complete all requirements as described within in the manner and time prescribed by the Brockton Public Schools. 15

19 2. Submit written reports, and attend meetings to inform school officials on the project s status. 3. Submit a final report at the conclusion of the project. F. TIME REQUIREMENTS/REQUIRED DELIVERY DATE Detail of proposed services to be delivered including an appropriate time line for providing those services assuming a July 1, 2014 start date and continuation of services, no later than June 30, G. PRICE PROPOSALS The Brockton Public Schools will only consider proposals that pay the contractor on a performance percentage fee basis as described herein. Proposal fees must be expressed as a percentage of the total net reimbursements from third parties that are received by the Brockton Public Schools for medical and health related services related to children enrolled in the School System. Fixed fee cost proposals will not be considered responsive to this proposal and will result in applicant disqualification. For example, if the fee percentage is 5% and then reimbursements received are $1,000,000, the total fee paid to the contractor will be $50,000. This formula is predicated on any billing and collection systems above and beyond what is already being done in the School Department. Payments will be made to the contractor only after the receipt of Medicaid revenue by the School Department. H. EQUIPMENT REQUIREMENTS The proposer must show it has adequate equipment and technology for: 1. Any/all tasks and/or activities as identified in Section B (Scope) of this RFP. 2. Applicants will be required to describe the hardware, software and operating systems they intend to use in order to fulfill the aforementioned requirements in Section B (Scope). All responsive proposers must be able to read information from Munis financials on Lenox operating system and the database system is Informix into their own systems. These are the computer systems currently available within the Brockton Public Schools. I. WRITTEN GUARANTEE The contractor shall submit a signed written statement guaranteeing: 1. The ability to commence providing services by the date specified in the proposal. 2. The ability to carry out the full volume of services specified in detail in their proposal. J. FUTURE DISALLOWANCE OF CLAIM PAYMENTS The contractor will provide assurances that maximized revenue that results from this proposal may be subject to a future audit and disallowance from claim payments. 16

20 MINIMUM EVALUATION CRITERIA The City will reject any proposal that does not meet the minimum evaluation criteria. A No Response to items 1 through 6 or a failure to respond to any of the following minimum evaluation criteria will result in a rejection of your proposal. Circle YES or NO for each of the following criteria: 1. Proposer has provided third party reimbursement maximization services and web-based special education data management and consulting services for at least eight (8) years. YES NO 2. Proposer has had success in developing third party billing, collection and management reporting systems for health services for at least five municipalities, school systems and/or state within the last 8 years. Successful means having clients who have received cash payments from third party payers, particularly Medicaid and/or private insurance. YES NO If yes, the applicant must submit as references, the names of at least three clients, their telephone number, their address, dates of service, brief description of services provided, approximate dollar amount received and contact person. It is preferred that five be submitted. The Brockton Public Schools will choose at random from each applicant at least two references to investigate. 3. The applicants work plan includes a detailed plan that highlights all processes and system implementation activities and specific deadlines for billing Medicaid and other insurance carriers within 60 days of contract award. YES NO 4. The proposers work plan includes a plan for further enhancement of Medicaid and other revenue maximization activities for areas of potential new reimbursements and the steps required to obtain revenue from those areas. These areas may include such topics as Transportation or Financial Services. YES NO 5. The proposers plan exhibits a knowledge of current Medicaid reimbursement rates, required informational needs, and the steps necessary to access Medicaid requirements. YES NO 6. The Project Leader proposed must have at least 6 years experience in school-based Medicaid reimbursements. YES NO PROPOSAL FORM (Must be submitted) 17

21 COMPARATIVE EVALUATION CRITERIA Proposals which do not meet the requirements of this RFP will be considered non responsive and will be rejected. Each proposal will be evaluated by the following criteria and each will receive a rating basis of Highly Advantageous, Advantageous, Not Advantageous, and Unacceptable. Proposals shall be submitted on the forms provided. The vendor must include a summary document in your request for proposal to the Brockton Public Schools the location and/or page numbers for the answers to the minimum and comparative evaluation criteria on pages 18 and Years the Contractor has been in business. HIGHLY ADVANTAGEOUS ADVANTAGEOUS 15 years experience in School 10 years experience in School Medicaid Reimb. Business and Medicaid Reimb. Business and Web-Based Special Education Data Web-Based Special Education Data Management and Consulting Services Management and Consulting Services NOT ADVANTAGEOUS UNACCEPTABLE 5 years experience in School 2 years experience in School Medicaid Reimb. Business and Medicaid Reimb. Business and Web-Based Special Education Data Web-Based Special Education Data Management and Consulting Services Management and Consulting Services 2. The number of people the Contractor can assign to the project. HIGHLY ADVANTAGEOUS ADVANTAGEOUS 8 or more people 6 people NOT ADVANTAGEOUS UNACCEPTABLE 4 people 2 or less people 3. Total dollar amount collected (received) on behalf of other school districts. HIGHLY ADVANTAGEOUS ADVANTAGEOUS More than Twelve Million Dollars Eight to Twelve Million Dollars NOT ADVANTAGEOUS Four to Eight Million Dollars UNACCEPTABLE Less than Four Million 4. Average size of school districts Contractor has or is currently contracted with. HIGHLY ADVANTAGEOUS ADVANTAGEOUS 15,000 or more students 10,000-15,000 students NOT ADVANTAGEOUS UNACCEPTABLE 5,000-10,000 students Less than 5,000 students PROPOSAL FORM (Must be submitted) 18

22 BID SUBMISSION REQUIREMENTS Failure to submit documents requested may result in the determination that your proposal is non responsive. Proposals must be submitted in a large sealed envelope which is plainly marked on the face PROPOSALS FOR MEDICAID REVENUE MAXIMIZATION INITIATIVE AND DATA MANAGEMENT SYSTEM. Inside the large sealed envelope must include two sections each in themselves in seperately sealed envelopes in accordance with any/all RFP specifications. 1. Non-Price Proposal (MRMIDMS) Including narrative, attachments and various responses to RFP s sections. 2. Price Proposal (MRMIDMS) One page form in the RFP. 19

23 FY2015 MEDICAID REVENUE MAXIMIZATION INITIATIVE AND DATA MANAGEMENT SYSTEM FOR BROCKTON PUBLIC SCHOOLS The price for any/all MRMIDMS services delivered to the City of Brockton beginning on the date of the award from July 1, 2014 until June 30, The total price, based on the previous performance based criteria is: July 1, 2014 to June 30, 2017 % This is based on the percentage of the total net reimbursement received by the City of Brockton for medical and other health related services provided to children enrolled in the Brockton Public Schools. Said percentage to be payable after reimbursement is received, based on augmentation, supplementation and/or revision of the current in-house system in the City. The price quotation must be guaranteed for the entire life of the Contractor s agreement with the City. NAME OF PROPOSER: ADDRESS: TELEPHONE: BY: AUTHORIZED SIGNATURE DATE: PRICE PROPOSAL FORM (Must be submitted) 20