Independent Long-Term Care External Review

Agency: State Government of Maine
State: Maine
Level of Government: State & Local
Category:
  • Q - Medical Services
Opps ID: NBD15098925606930750
Posted Date: Jul 28, 2020
Due Date: Aug 17, 2020
Solicitation No: 202007114
Source: Members Only
rfp# rfp title issuing department date posted Q&A and Amendment due date status awarded vendor next anticipated rfp release
202007114 Independent Long-Term Care External Review DPFR July 28, 2020

August 17, 2020 Open Early 2025

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STATE OF MAINE

DEPARTMENT OF PROFESSIONAL AND FINANCIAL REGULATION

BUREAU OF INSURANCE

RFP# 202007114

Independent Long-Term Care External Review

RFP Coordinator

All communication regarding this RFP must be made through the RFP Coordinator identified below.

Name: Pamela Stutch Title: Attorney

Contact Information: pamela.stutch@maine.gov

Submitted Questions Due

All questions must be received by the RFP Coordinator identified above by:

Date: August 4, 2020, no later than 11:59 p.m., local time

Proposal Submission

Proposals must be received by the Division of Procurement Services by:

Submission Deadline: August 17, 2020, no later than 11:59 p.m., local time.

Proposals must be submitted electronically to the following address:

Electronic (email) Submission Address: Proposals@maine.gov


TABLE OF CONTENTS

Page

PUBLIC NOTICE 3

RFP DEFINITIONS/ACRONYMS 4

PART I INTRODUCTION 5

A. PURPOSE AND BACKGROUND 5

B. GENERAL PROVISIONS 5

C. ELIGIBILITY TO SUBMIT BIDS 6

D. CONTRACT TERMS 6

E. NUMBER OF AWARDS 6

PART II SCOPE OF SERVICES TO BE PROVIDED 7

PART III KEY RFP EVENTS 9

A. QUESTIONS 9

B. AMENDMENTS 9

C. SUBMITTING THE PROPOSAL 9

PART IV PROPOSAL SUBMISSION REQUIREMENTS 11

A. PROPOSAL FORMAT 11

B. PROPOSAL CONTENTS 12

PART V PROPOSAL EVALUATION AND SELECTION 14

A. EVALUATION PROCESS – GENERAL INFORMATION 14

B. SCORING WEIGHTS AND PROCESS 14

C. SELECTION AND AWARD 15

D. APPEAL OF CONTRACT AWARDS 15

PART VI CONTRACT ADMINISTRATION AND CONDITIONS 16

A. CONTRACT DOCUMENT 16

B. STANDARD STATE AGREEMENT PROVISIONS 16

PART VII RFP APPENDICES AND RELATED DOCUMENTS 17

APPENDIX A – PROPOSAL COVER PAGE 18

APPENDIX B – DEBARMENT, PERFORMANCE AND

NON-COLLUSION CERTIFICATION 19

APPENDIX C – QUALIFICATIONS AND EXPERIENCE FORM 20

APPENDIX D – COST PROPOSAL FORM 23

APPENDIX E – SUBMITTED QUESTIONS FORM 24


PUBLIC NOTICE

*************************************************

State of Maine

Department of Professional and Financial Regulation

RFP# 202007114

Independent Long-Term Care External Review

The State of Maine Department of Professional and Financial Regulation, Bureau of Insurance, requires the services of Independent Long-Term Care External Review Organizations.

A copy of the RFP, as well as the Question & Answer Summary and all amendments related to this RFP, can be obtained at the following website: https://www.maine.gov/dafs/bbm/procurementservices/vendors/rfps

Proposals must be submitted to the State of Maine Division of Procurement Services, via e-mail, to the following email address: Proposals@maine.gov . Proposal submissions must be received no later than 11:59 pm, local time, on August 17, 2020. Proposals will be opened at the Burton M. Cross Office Building, 111 Sewall Street - 4th Floor, Augusta, Maine the following business day. Proposals not submitted to the Division of Procurement Services’ aforementioned email address by the aforementioned deadline will not be considered for contract award.

*************************************************


RFP DEFINITIONS/ACRONYMS

The following terms and acronyms shall have the meaning indicated below as referenced in this RFP:

Term/Acronym

Definition

Bureau

Bureau of Insurance

Department

Department of Professional and Financial Regulation

IRO

Independent Review Organization

RFP

Request for Proposal

State

State of Maine

URAC

Utilization Review Accreditation Organization


State of Maine - Department of Professional and Financial Regulation

RFP# 202007114

Independent Long-Term Care External Review

PART I INTRODUCTION

A. Purpose and Background

The Department is seeking proposals to provide the Long-Term Care Independent External Reviews as defined in this RFP document. This document provides instructions for submitting proposals, the procedure and criteria by which the Provider(s) will be selected, and the contractual terms which will govern the relationship between the State and the awarded Bidder(s).

The Bureau seeks proposals for furnishing all qualified personnel, facilities, materials and services to conduct Long-Term Care Independent External Reviews pursuant to 24-A M.R.S. § 5083 and Bureau of Insurance Rule Chapters 420 and 425 .

Title 24-A M.R.S. § 5083 provides that insureds have the right to appeal a denied claim to external review after exhausting a carrier’s internal appeals process. Bureau of Insurance Rule Chapters 420 and 425 clarify that the right of external review applies to claims involving benefit triggers and certain policy limitations and exclusions that require the exercise of professional judgement within the scope of practice of a health care professional.

The Bureau oversees the external review process. The rules require that the Bureau contract with qualified long-term care insurance IROs to conduct independent reviews upon the request of an insured or an insured’s representative. The external reviewer’s decision is binding on the carrier.

B. General Provisions

1. From the time this RFP is issued until award notification is made, all contact with the State regarding this RFP must be made through the aforementioned RFP Coordinator. No other person/State employee is empowered to make binding statements regarding this RFP. Violation of this provision may lead to disqualification from the bidding process, at the State’s discretion.

2. Issuance of this RFP does not commit the Department to issue an award or to pay expenses incurred by a Bidder in the preparation of a response to this RFP. This includes attendance at personal interviews or other meetings and software or system demonstrations, where applicable.

3. All proposals should adhere to the instructions and format requirements outlined in this RFP and all written supplements and amendments (such as the Summary of Questions and Answers), issued by the Department. Proposals are to follow the format and respond to all questions and instructions specified below in the “Proposal Submission Requirements” section of this RFP.

4. Bidders shall take careful note that in evaluating a proposal submitted in response to this RFP, the Department will consider materials provided in the proposal, information obtained through interviews/presentations (if any), and internal Departmental information of previous contract history with the Bidder (if any). The Department also reserves the right to consider other reliable references and publicly available information in evaluating a Bidder’s experience and capabilities.

5. The proposal shall be signed by a person authorized to legally bind the Bidder and shall contain a statement that the proposal and the pricing contained therein will remain valid and binding for a period of 180 days from the date and time of the bid opening.

6. The RFP and the selected Bidder’s proposal, including all appendices or attachments, shall be the basis for the final contract, as determined by the Department.

7. Following announcement of an award decision, all submissions in response to this RFP will be considered public records available for public inspection pursuant to the State of Maine Freedom of Access Act (FOAA) (1 M.R.S. §§ 401 et seq.).

State of Maine Freedom of Access Act

8. The Department, at its sole discretion, reserves the right to recognize and waive minor informalities and irregularities found in proposals received in response to this RFP.

9. All applicable laws, whether or not herein contained, shall be included by this reference. It shall be the Bidder’s responsibility to determine the applicability and requirements of any such laws and to abide by them.

C. Eligibility to Submit Bids

All interested parties are invited to submit bids in response to this Request for Proposals.

D. Contract Term

The Department is seeking a cost-efficient proposal(s) to provide services, as defined in this RFP, for the anticipated contract period defined in the table below. Please note that the dates below are estimated and may be adjusted, as necessary, in order to comply with all procedural requirements associated with this RFP and the contracting process. The actual contract start date will be established by a completed and approved contract.

Contract Renewal: Following the initial term of the contract, the Department may opt to renew the contract for two renewal periods of one year each, subject to continued availability of funding and satisfactory performance.

The term of the anticipated contract, resulting from this RFP, is defined as follows:

Period

Start Date

End Date

Initial Period of Performance

October 1, 2020

September 30, 2022

Renewal Period #1

October 1, 2022

September 30, 2024

Renewal Period #2

October 1, 2024

September 30, 2025

E. Number of Awards

The Department anticipates awarding up to three (3) contracts as a result of this RFP process. Multiple contracts for these services are necessary in order to mitigate conflict of interest matters and availability issues. If three awards are made, it is anticipated that long term care insurance external review cases will be assigned in a contractor queue with the first three assignments being made to the contractors in order of their RFP proposal scores, going from highest to lowest. The fourth case will repeat the queue, as the highest scoring contractor will be assigned that fourth case. This hypothetical rotation assumes no conflict of interest matters and no availability issues when cases are assigned. In the event of a conflict of interest disqualification or provider unavailability, cases will be assigned to the next contractor in queue.


PART II SCOPE OF SERVICES TO BE PROVIDED

The IRO shall furnish all the personnel, facilities, materials, supplies, and other necessary items to facilitate the work and shall perform all the work set out and described in the specifications below. The scope of services to be performed by the IRO shall include review of insurer’s adverse benefit determinations eligible for external review. The adverse benefit determinations eligible for external review are those claim denials involving benefit triggers and certain policy limitations and exclusions that require the exercise of professional judgement within the scope of practice of a health care professional.

The Bureau will review and assign cases to the IRO. In all cases, the insured will have exhausted his or her internal appeal rights as provided for under Bureau of Insurance Rule Chapters 420 or 425 . The insured, or insured’s representative, may request to participate in the external review by teleconference or other reasonable technological means.

If the insured or the insured’s representative requests a telephonic or other technologically facilitated hearing, the IRO must conduct the hearing in a fair and impartial manner, giving the insured, the insured’s representative (if applicable), and the carrier the opportunity to present their positions and ask questions of the other side, including allowing adequate time for the insured, the insured’s representative (if applicable), and the carrier to present their positions. The IRO, including the licensed health care professional participating in the hearing, shall not render a decision on the matter during the course of the hearing.

The IRO must record the hearing and provide the Bureau with a copy of such hearing upon request.

The IRO shall review the case and issue a detailed written Notice of Decision within 30 calendar days from the date the IRO received the case from the Bureau. In rendering the written decision, the IRO must give consideration to: (1) all relevant clinical information relating to the insured’s physical and mental condition, including any competing clinical information; and (2) all relevant clinical standards and guidelines, including, but not limited to, those standards and guidelines relied upon by the insurer. The IRO must provide the name and qualifications of the health care professional conducting the review.

The rules require that at minimum, an IRO must have on staff or contract with a qualified and licensed health care professional in an appropriate field for determining an insured’s functional or cognitive impairment (e.g., physical therapy, occupational therapy, neurology, physical medicine and rehabilitation) to conduct the review. The IRO must demonstrate that it has, on staff or via contract, a licensed health care practitioner qualified to certify that an individual is chronically ill for purposes of a qualified long-term care insurance contract.

The IRO must have written policies and procedures that govern all aspects of the external review. This will include, at minimum, a quality assurance mechanism that ensures:

1. That the external review is conducted within the specified time frame.

2. The selection of a qualified and impartial licensed health care professional to conduct the review.

3. The confidentiality of medical and treatment records.

4. That there are no professional, familial, or financial conflicts of interest relating to the insurer, the insured, or the insured’s authorized representative or long-term care provider involved in the external review.

5. That neither the IRO nor its licensed health care professional who conducts the reviews may receive compensation of any type that is dependent on the outcome of the review.

Proposals shall be prepared in accordance with, and address, the requirements in Rule Chapters 420 and 425.


PART III KEY RFP EVENTS

A. Questions

1. General Instructions

a. It is the responsibility of all Bidders and other interested parties to examine the entire RFP and to seek clarification, in writing, if they do not understand any information or instructions.

b. Bidders and other interested parties should use Appendix E – Submitted Questions Form – for submission of questions.

c. The Submitted Questions Form must be submitted by e-mail and received by the RFP Coordinator, identified on the cover page of this RFP, as soon as possible but no later than the date and time specified on the RFP cover page.

d. Submitted Questions must include the RFP Number and Title in the subject line of the e-mail. The Department assumes no liability for assuring accurate/complete/on time e-mail transmission and receipt.

2. Question & Answer Summary: Responses to all questions will be compiled in writing and posted on the following website no later than seven (7) calendar days prior to the proposal due date: Division of Procurement Services RFP Page . It is the responsibility of all interested parties to go to this website to obtain a copy of the Question & Answer Summary. Only those answers issued in writing on this website will be considered binding.

B. Amendments

All amendments released in regard to this RFP will also be posted on the following website: Division of Procurement Services RFP Page . It is the responsibility of all interested parties to go to this website to obtain amendments. Only those amendments posted on this website are considered binding.

C. Submitting the Proposal

1. Proposals Due: Proposals must be received no later than 11:59 p.m. local time, on the date listed on the cover page of this RFP, at which point they will be opened. Proposals received after the 11:59 p.m. deadline will be rejected without exception.

2. Delivery Instructions: Email proposal submissions are to be submitted to the State of Maine Division of Procurement Services, via email, to the email address provided on the RFP Cover Page ( Proposals@maine.gov ).

a. Only proposals received by email will be considered. The Department assumes no liability for assuring accurate/complete e-mail transmission and receipt.

b. Bidders are to insert the following into the subject line of their email submission:

“RFP# 202007114 Proposal Submission”

c. Bidder’s proposals are to be broken down into multiple files, with each file named as it is titled in bold below, and include:

- File #1: PDF format preferred

Completed - Proposal Cover Page (Appendix A)

Debarment, Performance and Non-Collusion Certification (Appendix B)

- File #2: PDF format preferred

Organization Qualifications and Experience (Appendix C and all related/required attachments stated in PART IV, B., Section I.)

- File #3: PDF format preferred

Proposed Services (and all related/required attachments stated in PART IV, B., Section II.)

- File #4: PDF format preferred

Cost Proposal (Appendix D and all related/required attachments stated in PART IV, B., Section III.)


PART IV PROPOSAL SUBMISSION REQUIREMENTS

This section contains instructions for Bidders to use in preparing their proposals. The Bidder’s proposal must follow the outline used below, including the numbering and section and sub-section headings as they appear here. Failure to use the outline specified in this section, or to respond to all questions and instructions throughout this document, may result in the proposal being disqualified as non-responsive or receiving a reduced score. The Department, and its evaluation team for this RFP, has sole discretion to determine whether a variance from the RFP specifications should result in either disqualification or reduction in scoring of a proposal. Rephrasing of the content provided in this RFP will, at best, be considered minimally responsive. The Department seeks detailed yet succinct responses that demonstrate the Bidder’s experience and ability to perform the requirements specified throughout this document.

A. Proposal Format

1. All pages of a Bidder’s proposal should be numbered consecutively beginning with number 1 on the first page of the narrative (this does not include the cover page or table of contents pages) through to the end, including all forms and attachments. For clarity, the Bidder’s name should appear on every page, including Attachments. Each Attachment must reference the section or subsection number to which it corresponds.

2. The Bidder is asked to be brief and concise in responding to the RFP questions and instructions.

3. All electronic documents should be formatted for printing as formatting will not be adjusted prior to printing and reviewing these documents.

4. The Bidder may not provide additional attachments beyond those specified in the RFP for the purpose of extending their response. Additional materials not requested will not be considered part of the proposal and will not be evaluated.

5. Include any forms provided in the submission package or reproduce those forms as closely as possible. All information should be presented in the same order and format as described in the RFP.

6. It is the responsibility of the Bidder to provide all information requested in the RFP package at the time of submission. Failure to provide information requested in this RFP may, at the discretion of the Department’s evaluation review team, result in a lower rating for the incomplete sections and may result in the proposal being disqualified for consideration.

7. The Bidder should complete and submit the “Proposal Cover Page” provided in Appendix A of this RFP and provide it with the Bidder’s proposal. It is important that the cover page show the specific information requested, including Bidder address(es) and other details listed. The proposal cover page shall be dated and signed by a person authorized to enter into contracts on behalf of the Bidder.

8. The Bidder should complete and submit the “Debarment, Performance and Non-Collusion Certification Form” provided in Appendix B of this RFP. Failure to provide this certification may result in the disqualification of the Bidder’s proposal, at the discretion of the Department.


B. Proposal Contents

Section I   Organization Qualifications and Experience

1. Overview of the Organization

The Bidder is to complete Appendix C (Qualifications and Experience Form) describing their qualifications and skills to provide the requested services in this RFP. The Bidder is also to include three examples of projects which demonstrate their experience and expertise in performing these services as well as highlighting the Bidder’s stated qualifications and skills.

The bidder should also describe the history of the bidder’s organization, including skills pertinent to the specific work required by the RFP and any special or unique characteristics of the organization that would make it qualified to perform the required work activities. The bidder should provide similar information for any subcontractors.

All Bidders are asked to address any potential conflict of interest issues that may affect their availability to conduct the external review of cases referred by the Bureau.

2. Subcontractors

If subcontractors are to be used, provide a list that specifies the name, address, phone number, contact person, and a brief description of the subcontractors’ organizational capacity and qualifications.

3. Organizational Chart

Provide an organizational chart of the bidder’s organization. Each position must be identified by position title and corresponding to the personnel job descriptions and the Staffing Plan provided.

A directory of the organization’s contracted and internal licensed health care professionals is also to be provided.

4. Litigation

Attach a list of all current litigation in which the Bidder is named and a list of all closed cases that have closed within the past five (5) years in which Bidder paid the claimant either as part of a settlement or by decree.  For each, list the entity bringing suit, the complaint, the accusation, amount, and outcome.  If no litigation will be included, write “none” on submitted attachment.

5. Financial Viability

Provide the following information for each of the past three tax years:

- Balance Sheets

- Income (Profit/Loss) Statements

6. Licensure/Certification

Provide documentation of any applicable licensure/certification, including any URAC or similar accreditation.

7. Certificate of Insurance

Provide a certificate of insurance on a standard Acord form (or the equivalent) evidencing the Bidder’s general liability, professional liability and any other relevant liability insurance policies that might be associated with the proposed services.

8. Required Proposal Attachments

a. Appendix C

b. Organizational Chart

c. Directory of Contracted and Internal Licensed Healthcare Professionals

d. Accreditation Documents

e. Professional Membership Documents

Section II Proposed Services

Discuss the Scope of Services referenced above in Part II of this RFP and what the Bidder will offer. Give particular attention to describing the methods and resources you will use and how you will accomplish the tasks involved. Also, describe how you will ensure expectations and/or desired outcomes as a result of these services will be achieved. If subcontractors are involved, clearly identify the work each will perform.

Please address any potential conflict of interest issues that may affect the availability to conduct the external review of cases referred by the Bureau.

Bidders are to provide the following additional required documentation:

1. A copy of the organization’s written policy and procedures and quality control measures applicable to timely conducting external reviews.

2. A statement on the confidentiality of medical and treatment records.

3. A statement on procedures for the screening for any potential conflict of interest between the IRO or one of its internal or contracted licensed health care professionals and an insurer, an insured, an insured’s authorized representative or insured’s long-term care provider involved in an external review.

Section III Cost Proposal

1. General Instructions

a. The Bidder must submit a cost proposal that covers the entire period of the initial contract. Please use the expected “Initial Period of Performance” dates stated in PART I, D.

b. The cost proposal shall include the costs necessary for the Bidder to fully comply with the contract terms and conditions and RFP requirements.

c. No costs related to the preparation of the proposal for this RFP or to the negotiation of the contract with the Department may be included in the proposal. Only costs to be incurred after the contract effective date that are specifically related to the implementation or operation of contracted services may be included.

2. Cost Proposal Form Instructions

The Bidder should fill out Appendix D (Cost Proposal Form), following the instructions detailed here and in the form. Failure to provide the requested information, and to follow the required cost proposal format provided, may result in the exclusion of the proposal from consideration, at the discretion of the Department.


PART V PROPOSAL EVALUATION AND SELECTION

Evaluation of the submitted proposals shall be accomplished as follows:

A. Evaluation Process - General Information

1. An evaluation team, comprised of qualified reviewers, will judge the merits of the proposals received in accordance with the criteria defined in the RFP.

2. Officials responsible for making decisions on the selection of a contractor shall ensure that the selection process accords equal opportunity and appropriate consideration to all who are capable of meeting the specifications. The goals of the evaluation process are to ensure fairness and objectivity in review of the proposals and to ensure that the contract is awarded to the Bidder whose proposal provides the best value to the State of Maine.

3. The Department reserves the right to communicate and/or schedule interviews/presentations with Bidders if needed to obtain clarification of information contained in the proposals received, and the Department may revise the scores assigned in the initial evaluation to reflect those communications and/or interviews/presentations. Interviews/presentations are not required, and changes to proposals will not be permitted during any interview/presentation process. Therefore, Bidders should submit proposals that present their rates and other requested information as clearly and completely as possible.

B. Scoring Weights and Process

1. Scoring Weights: The score will be based on a 100-point scale and will measure the degree to which each proposal meets the following criteria.

Section I. Organization Qualifications and Experience (30 points)

Includes all elements addressed above in Part IV, B, Section I.

Section II. Proposed Services (30 points)

Includes all elements addressed above in Part IV, B, Section II.

Section III. Cost Proposal (40 points)

Includes all elements addressed above in Part IV, B, Section III.

2. Scoring Process: The review team will use a consensus approach to evaluate and score Sections I & II above. Members of the review team will not score those sections individually but, instead, will arrive at a consensus as to assignment of points for each of those sections. Sections III, the Cost Proposal, will be scored as described below.

3. Scoring the Cost Proposal: The rates/fixed costs provided in Appendix D for conducting all the functions specified in this RFP will be assigned scores according to mathematical formulas. The lowest bid in each category will be awarded the full amount of points available in that category. Proposals with higher bids values will be awarded proportionately fewer points calculated in comparison with the lowest bid.

The scoring formulas are:

(Lowest submitted “Standard External Review Cost with Hearing” / “Standard External Review Cost with Hearing” of proposal being scored) x 15 = pro-rated score

(Lowest submitted “Standard External Review Cost without Hearing” / “Standard External Review Cost without Hearing” of proposal being scored) x 15 = pro-rated score

(Lowest submitted “Withdrawn by Carrier Prior to Review” / “Withdrawn by Carrier Prior to Review” of proposal being scored) x 10 = pro-rated score

No Best and Final Offers: The State will not seek a best and final offer (BAFO) from any Bidder in this procurement process.  All Bidders are expected to provide their best value pricing with the submission of their proposal.

4. Negotiations: The Department reserves the right to negotiate with the successful Bidder to finalize a contract at the same rate or cost of service as presented in the selected proposal. Such negotiations may not significantly vary the content, nature or requirements of the proposal or the Department’s Request for Proposals to an extent that may affect the price of goods or services requested. The Department reserves the right to terminate contract negotiations with a selected Bidder who submits a proposed contract significantly different from the proposal they submitted in response to the advertised RFP. In the event that an acceptable contract cannot be negotiated with the highest ranked Bidder, the Department may withdraw its award and negotiate with the next-highest ranked Bidder, and so on, until an acceptable contract has been finalized. Alternatively, the Department may cancel the RFP, at its sole discretion.

C. Selection and Award

1. The final decision regarding the award of the contract will be made by representatives of the Department subject to approval by the State Procurement Review Committee.

2. Notification of contractor selection or non-selection will be made in writing by the Department.

3. Issuance of this RFP in no way constitutes a commitment by the State of Maine to award a contract, to pay costs incurred in the preparation of a response to this request, or to pay costs incurred in procuring or contracting for services, supplies, physical space, personnel or any other costs incurred by the Bidder.

4. The Department reserves the right to reject any and all proposals or to make multiple awards.

D. Appeal of Contract Awards

Any person aggrieved by the award decision that results from this RFP may appeal the decision to the Director of the Bureau of General Services in the manner prescribed in 5 MRSA § 1825-E and 18-554 Code of Maine Rules, Chapter 120 (found here: Chapter 120 ).  The appeal must be in writing and filed with the Director of the Bureau of General Services, 9 State House Station, Augusta, Maine, 04333-0009 within 15 calendar days of receipt of notification of contract award.


PART VI CONTRACT ADMINISTRATION AND CONDITIONS

A. Contract Document

1. The successful Bidder will be required to execute a State of Maine Service Contract with appropriate riders as determined by the issuing department.

The complete set of standard State of Maine Service Contract documents, along with other forms and contract documents commonly used by the State, may be found on the Division of Procurement Services’ website at the following link:

Division of Procurement Services Forms Page

2. Allocation of funds is final upon successful negotiation and execution of the contract, subject to the review and approval of the State Procurement Review Committee. Contracts are not considered fully executed and valid until approved by the State Procurement Review Committee and funds are encumbered. No contract will be approved based on an RFP which has an effective date less than fourteen (14) calendar days after award notification to Bidders. (Referenced in the regulations of the Department of Administrative and Financial Services, Chapter 110, § 3(B)(i): Chapter 110 )

This provision means that a contract cannot be effective until at least 14 calendar days after award notification.

3. The State recognizes that the actual contract effective date depends upon completion of the RFP process, date of formal award notification, length of contract negotiation, and preparation and approval by the State Procurement Review Committee. Any appeals to the Department’s award decision(s) may further postpone the actual contract effective date, depending upon the outcome. The contract effective date listed in this RFP may need to be adjusted, if necessary, to comply with mandated requirements.

4. In providing services and performing under the contract, the successful Bidder(s) shall act as an independent contractor and not as an agent of the State of Maine.

B. Standard State Agreement Provisions

1. Agreement Administration

Following the award, an Agreement Administrator from the Department will be appointed to assist with the development and administration of the contract and to act as administrator during the entire contract period. Department staff will be available after the award to consult with the successful Bidder in the finalization of the contract.

2. Payments and Other Provisions

The State anticipates paying the Contractor on the basis of net 30 payment terms, upon the receipt of an accurate and acceptable invoice. An invoice will be considered accurate and acceptable if it contains a reference to the State of Maine contract number, contains correct pricing information relative to the contract, and provides any required supporting documents, as applicable, and any other specific and agreed-upon requirements listed within the contract that results from this RFP.

PART VII LIST OF RFP APPENDICES AND RELATED DOCUMENTS

1. Appendix A – Proposal Cover Page

2. Appendix B – Debarment, Performance and Non-Collusion Certification

3. Appendix C – Qualifications and Experience Form

4. Appendix D – Cost Proposal Form

5. Appendix E – Submitted Question Form


APPENDIX A

State of Maine

Department of Professional and Financial Regulation

PROPOSAL COVER PAGE

RFP# 202007114

Independent Long-Term Care External Review

Bidder’s Organization Name:

Chief Executive - Name/Title:

Tel:

E-mail:

Headquarters Street Address:

Headquarters City/State/Zip:

(Provide information requested below if different from above)

Lead Point of Contact for Proposal - Name/Title:

Tel:

E-mail:

Headquarters Street Address:

Headquarters City/State/Zip:

• This proposal and the pricing structure contained herein will remain firm for a period of 180 days from the date and time of the bid opening.

• No personnel currently employed by the Department or any other State agency participated, either directly or indirectly, in any activities relating to the preparation of the Bidder’s proposal.

• No attempt has been made, or will be made, by the Bidder to induce any other person or firm to submit or not to submit a proposal.

• The above-named organization is the legal entity entering into the resulting agreement with the Department should they be awarded the contract.

• The undersigned is authorized to enter contractual obligations on behalf of the above-named organization.

To the best of my knowledge, all information provided in the enclosed proposal, both programmatic and financial, is complete and accurate at the time of submission.

Name (Print):

Title:

Authorized Signature:

Date:

APPENDIX B

State of Maine

Department of Professional and Financial Regulation

DEBARMENT, PERFORMANCE and NON-COLLUSION CERTIFICATION

RFP# 202007114

Independent Long-Term Care External Review

Bidder’s Organization Name:

By signing this document, I certify to the best of my knowledge and belief that the aforementioned organization, its principals and any subcontractors named in this proposal:

a. Are not presently debarred, suspended, proposed for debarment, and declared ineligible or voluntarily excluded from bidding or working on contracts issued by any governmental agency.

b. Have not within three years of submitting the proposal for this contract been convicted of or had a civil judgment rendered against them for:

i. Fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a federal, state or local government transaction or contract.

ii. Violating Federal or State antitrust statutes or committing embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, or receiving stolen property;

iii. Are not presently indicted for or otherwise criminally or civilly charged by a governmental entity (Federal, State or Local) with commission of any of the offenses enumerated in paragraph (b) of this certification; and

iv. Have not within a three (3) year period preceding this proposal had one or more federal, state or local government transactions terminated for cause or default.

c. Have not entered into a prior understanding, agreement, or connection with any corporation, firm, or person submitting a response for the same materials, supplies, equipment, or services and this proposal is in all respects fair and without collusion or fraud. The above-mentioned entities understand and agree that collusive bidding is a violation of state and federal law and can result in fines, prison sentences, and civil damage awards.

Failure to provide this certification may result in the disqualification of the Bidder’s proposal, at the discretion of the Department.

Name (Print):

Title:

Authorized Signature:

Date:


APPENDIX C

State of Maine

Department of Professional and Financial Regulation

QUALIFICATIONS & EXPERIENCE FORM

RFP# 202007114

Independent Long-Term Care External Review

Bidder’s Organization Name:

Present a brief statement of qualifications, including any applicable licensure and/or certification. Describe the history of the Bidder’s organization, especially regarding skills pertinent to the specific work required by the RFP and any special or unique characteristics of the organization which would make it especially qualified to perform the required work activities. You may expand this form and use additional pages to provide this information.

APPENDIX C (continued)

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