STATE OF FLORIDA AGENCY FOR HEALTH CARE ADMINISTRATION REQUEST FOR INFORMATION RFI /15 PROVISION OF NON-EMERGENCY TRANSPORTATION SERVICES

Transcription

1 STATE OF FLORIDA AGENCY FOR HEALTH CARE ADMINISTRATION REQUEST FOR INFORMATION RFI /15 PROVISION OF NON-EMERGENCY TRANSPORTATION SERVICES A. BACKGROUND/PURPOSE 1. Background In accordance with section , Florida Statutes and Rule 59G-4.330, the Agency for Health Care Administration (Agency) must ensure Medicaid recipients are provided timely and appropriate access to non-emergency transportation to medical services if the Medicaid recipient has no other means to access services. The Agency recently completed its implementation of the Statewide Medicaid Managed Care (SMMC) program, wherein most Medicaid recipients will receive their services, including transportation, through a Medicaid managed care plan. Medicaid recipients who are not enrolled in the SMMC program, but who are eligible for transportation services, will need to receive their services through a vendor or vendors contracted with the Agency. These individuals are: Medicaid recipients receiving services in a prescribed pediatric extended care center; Medicaid recipients who are eligible for Medicaid only because they have breast or cervical cancer; Medicaid recipients who are presumptively eligible pregnant women; Medicaid recipients with other creditable health care coverage (i.e., third party liability), excluding Medicare; Medicaid recipients enrolled in Medicaid with Medically Needy coverage; Medicaid recipients enrolled in the Individual Budgeting (ibudget) Home and Community Based Services Waiver, pursuant to Chapter 393 Florida Statutes; Medicaid recipients waiting for ibudget waiver services; and Medicaid recipients who are awaiting enrollment into an SMMC Managed Medical Assistance managed care plan. The Agency is seeking information to assist in determining whether to contract with a vendor on a statewide basis or with a vendor(s) on a regional basis. The potential regions are as follows: AHCA RFI /15, Page 1 of 5

2 Geographic Regions Counties Northern Region Escambia, Santa Rosa, Okaloosa, Walton, Holmes, Washington, Jackson, Bay, Calhoun, Gulf, Liberty, Gadsden, Liberty, Franklin, Wakulla, Leon, Jefferson, Madison, Taylor, Hamilton, Suwannee, Lafayette, Dixie, Columbia, Gilchrist, Levy, Union, Alachua, Bradford, Putnam, Marion, Citrus, Lake, Hernando, Sumter, Nassau, Baker, Duval, Clay, St. Johns, Flagler, Volusia Central Region Pasco, Pinellas, Hillsborough, Manatee, Polk, Hardee, Highlands, Seminole, Orange, Osceola, Brevard Southern Region Sarasota, DeSoto, Charlotte, Glades, Lee, Hendry, Collier, Indian River Okeechobee, St. Lucie, Martin, Palm Beach, Broward, Miami-Dade, Monroe The Agency intends to reimburse any selected vendor(s) through a capitated (per member per month) payment methodology. 2. Purpose Through this Request for Information (RFI), the Agency is seeking information from vendors who have experience in and/or knowledge of the provision of providing nonemergency transportation services to eligible recipients not enrolled in a managed care plan. The Agency is interested in obtaining information regarding operating comparable services/programs in Florida and in other states for the Medicaid population, as well as best practices and innovations in business models and service delivery. a. Respondents to this RFI should provide information outlined in Section B., RFI Response Instructions, below regarding approaches and intended capability of providing transportation services to Medicaid eligible recipients (as described in Section A.1. above) with varying medical needs, which include: 1) Staffing requirements; 2) Determining the recipient s eligibility for the service and what type of transportation is needed; 3) Procedure for providing prior authorization to recipients or providers (on the recipient s behalf) requesting transportation services; 4) Maintaining a sufficient network of transportation providers (either directly through its own network of transportation providers or through a provider contract relationship); AHCA RFI /15, Page 2 of 5

3 5) Ensuring compliance with all applicable federal and state regulations, including the Americans with Disabilities Act requirements, vehicle and equipment safety standards, etc.; 6) Compliance with encounter data submission requirements; 7) Utilization monitoring and reporting; and 8) Procedures for providing transportation services outside of a region. b. A Request for Information is not a method of procurement. Responses to a RFI are not offers and shall not be accepted by the Agency to form a binding contract. The Agency reserves the right to utilize the information gathered through the RFI process to develop a scope of services, which may be incorporated into a contract using a statutorily approved method of procurement. B. RFI RESPONSE INSTRUCTIONS Respondents to this RFI are asked to be thorough, but concise. The RFI response must include the following: 1. The respondent s name, place of business address(es), contact information, including representative name and alternative, if available, telephone number(s) and address(es); 2. A description of the respondent s business and its experience as it relates to the services outlined in this RFI. This description should include a narrative explaining past experiences in which the respondent has engaged with other health care agencies, health care providers or government agencies to deliver services pertaining to the delivery of non-emergency medical transportation services; 3. A statement of interest in or knowledge of the services outlined in this RFI, including a high level outline of any specific product, concept, technology or approach that would pertain to the information sought through this RFI including, but not limited to: a. Information concerning what would be an appropriate implementation schedule for developing a sufficient transportation network and system to coordinate, deliver, monitor and track all non-emergency transportation services; b. A description of anticipated key staffing and network requirements, including vehicle descriptions, to best operate the non-emergency transportation; c. A description of any applicable information system(s) and how it effectively enables: 1) Collection and reporting of utilization encounter data; 2) Accurate and timely reporting of encounter data in the required Agency format (50/10); and AHCA RFI /15, Page 3 of 5

4 3) Receipt of any timely payment of claims. d. An estimate regarding the cost to provide the aforementioned services in accordance with the information herein on a per-member-per-month basis. 4. Respondents are encouraged to utilize the following resources in preparation of their responses to the RFI. Resource documents can be accessed via the links included below. a. The Medicaid Non-Emergency Transportation Coverage and Limitations Policy Handbook; this document describes the coverage and limitations policies that govern reimbursement for non-emergency transportation under the Florida Medicaid program: b. The August 2014 August 2015 non-emergency transportation capitation rates developed by Milliman. This provides the Agency s capitation rates for nonemergency transportation services: c. Transportation Data Book; this document provides historical transportation data/costs and summarizes the base data used to develop the capitation rates, including numbers of riders by county: C. PROPRIETARY INFORMATION Any portion of the submitted response which is asserted to be exempt from disclosure under Chapter 119, Florida Statutes, shall be clearly marked exempt, confidential, or trade secret (as applicable) and shall also contain the statutory basis for such claim on every page. Pages containing trade secrets shall be marked trade secret as defined in Section , Florida Statutes. Failure to segregate and identify such portions shall constitute a waiver of any claimed exemption and the Agency will provide such records in response to public records requests without notifying the respondent. Designating material simply as proprietary will not necessarily protect it from disclosure under Chapter 119, Florida Statutes. An entire response should not be considered trade secret. D. RESPONSE SUBMISSION A RFI is not a method of procurement. Responses to a RFI are not offers and shall not be accepted by the Agency to form a binding contract. This RFI shall not directly result in the execution of a contract with the Agency. The Agency reserves the right to utilize the information gathered through the RFI process to develop a scope of services, which may be incorporated into a contract using a statutorily approved method of procurement. AHCA RFI /15, Page 4 of 5

5 Respondents to this RFI shall submit one (1) electronic copy of its response, which shall not exceed one hundred, one-sided, pages in length. Responses may be submitted on CD-ROM or via to the Agency contact included below. The software used to produce the electronic files must be Microsoft Word 97 and/or Excel 97 or newer. The electronic files must be logically named. The respondent shall also submit one (1) electronic redacted copy of the response suitable for release to the public. Any confidential or trade secret information covered under Section , Florida Statutes, should be either redacted or completely removed. The redacted response shall be marked as the redacted copy and contain a transmittal letter authorizing release of the redacted version of the response in the event the Agency receives a public records request. Responses to this RFI shall be provided no later than 5:00 PM, Eastern Standard Time, November 18, Responses shall be submitted to: Agency for Health Care Administration Procurement Office Attn: LeAnn Clayton 2727 Mahan Drive, MS 15 Tallahassee, FL ProcurementAdministration@ahca.myflorida.com E. VENDOR COSTS Vendors are responsible for all costs associated with preparing a response to this RFI. The state of Florida, Agency for Health Care Administration, will not be responsible for any vendor costs associated with preparing a response to this RFI. F. QUESTIONS Questions concerning this RFI should be submitted in writing via to LeAnn Clayton at ProcurementAdministration@ahca.myflorida.com All responses to questions received will be made, in writing, directly to the sender. G. AGENCY FOR HEALTH CARE ADMINISTRATION WEBSITE Additional information about the Florida Agency for Health Care Administration can be found on the Agency s website at: REMAINDER OF PAGE INTENTIONALLY LEFT BLANK AHCA RFI /15, Page 5 of 5