Basic Health Plan audit

Agency: The New York State Contract Reporter
State: New York
Level of Government: State & Local
Category:
  • Q - Medical Services
Opps ID: NBD15621265372418624
Posted Date: Oct 3, 2017
Due Date: Nov 2, 2017
Source: Members Only
Issue Date: 10/03/2017 Contract Number: TBD
Basic Health Plan audit
Description:

Title: Basic Health Plan (BHP) Audit

Agency: NYS Department of Health, Office of Health Insurance Programs

Contract Number: TBD

Contract Term: 1/1/2018 ? 12/31/2018

Posted Date: October 2, 2017

Submission of Questions: October 11, 2017

Due Date/Time: November 2, 2017, 4:00 PM

County (ies): Albany County

Location: 99 Washington Avenue, Albany New York

Opportunity Type: Discretionary procurements between $50,000 and $200,000

Description

Pursuant to its discretionary purchasing authority under State Finance Law 163(6), the New York State Department of Health (DOH), Office of Health Insurance Programs (OHIP), intends to contract with an independent Public Accounting firm that has a New York State (NYS) licensed Certified Public Accountant (CPA) on staff or an independent CPA licensed in NYS, to conduct an independent audit of BHP trust fund expenditures, consistent with the standards set forth in Chapter 3 of Government Accountability Offices Government Auditing Standards, over a three (3) year period to determine the expenditures made during the three (3) year period, April 1, 2015 through March 31, 2018, were allowable as described in Federal Regulation 600.705(b) and in accord with other applicable Federal requirements. This procurement opportunity is limited to New York State Small Businesses, New York State certified Service Disabled Veteran Owned Businesses and businesses certified pursuant to Article 15-A of the New York State Executive Law.

BACKGROUND

Section 1331(s) of the Affordable Care Act (ACA) provides States the option of creating a BHP, an affordable health benefits coverage program for individuals with family incomes between 133 percent and 200 percent of the Federal Poverty Level (FPL) and for individuals with family incomes below 138 percent FPL who are lawfully present in the United States but do not qualify for Federally financed Medicaid due to their immigration status. New York State implemented the BHP, branded as Essential Plan, April 1, 2015. Section 2380-F of the Federal Register requires an independent audit of BHP trust fund expenditures consistent with the standards set forth in Chapter 3 of Government Accountability Offices Government Auditing Standards, over a three (3) year period to determine the expenditures made during the three (3) year period were allowable as described in 600.705(b) and in accord with other applicable Federal requirements.

Additional information on the BHP can be found here: http://www.health.ny.gov/health_care/managed_care/essential/2015-dec_annual_rpt.htm

Deliverables

The Contractor must:

  1. Conduct an independent audit, performed by a CPA, of BHP trust fund expenditures, consistent with the standards set forth in Chapter 3 of Government Accountability Offices Government Auditing Standards, over a three (3) year period to determine the expenditures made during the three (3) year period, April 1, 2015 through March 31, 2018, were allowable as described in Federal Regulation 600.705(b) and in accord with other applicable Federal requirements.

  1. Submit a written audit guide, policy, and procedure manual to the DOH manager thirty (30) days prior to initiation of the audit. The DOH must approve all submitted documents before the audit can begin. The contractor must utilize the audit protocols set forth in Attachment 1 to prepare the audit.

  1. Conduct an independent audit of BHP trust fund expenditures over a three (3) year period from April 1, 2015 through March 31, 2018.

  1. Submit a draft audit report no later than June 30, 2018.

  1. Submit a final audit report no later than July 31, 2018.

  1. Testify to the audit process and the basis for audit findings in hearings, if necessary, and in legal proceedings which could include other administrative, civil, or criminal proceedings, related to work performed pursuant to this agreement. These services will not be compensated separately and must be included in the deliverable price.

  1. Provide additional correspondence to DOH until the final audit report has been approved. Correspondence will include attending conference calls with DOH on an as needed basis, to clarify how the audits were performed and to support the audit findings. These services will not be compensated separately and must be included in the deliverable prices.

PROPOSAL REQUIREMENTS:

Interested parties should submit proposals with the following information to DOH:

  1. Provide a brief description of how the bidder meets all the minimum qualifications as outlined in the above section.
  2. Provide a brief narrative of the process the bidder will use to complete the BHP audit and how the bidder ensures the audit will be delivered within the required time frame.
  3. Provide a description of the experience(s) the bidder has had performing audits or reviews in the regulatory and health care environment. Describe the bidders experience in conducting financial audits of similar nature.
  4. Bidder should describe their organizational structure and background.
  5. Provide a description of your data processing and analytical capabilities including any technologies, special techniques, skills or abilities that the bidder will use to complete this audit.
  6. Provide examples of reports that demonstrate the bidders capacity to summarize findings of audits.
  7. Provide three (3) references from clients which the bidder is supplying or has supplied services similar to those required in this solicitation. References should include: description of audit, client or firm name, contact name(s), telephone number(s) and audit date to demonstrate previous experience with similar audits.
  8. Complete and sign the Cost Proposal Form attached to this advertisement (Attachment 2). Please submit the completed Cost Proposal as a separate PDF file. To complete this form, bidders should provide an all-inclusive deliverable price for the completion of the BHP audit. Upon completion of the audit, the Contractor will be reimbursed 15% of the audit bid price upon acceptance of the written audit guide, policy, and procedure manual, 70% upon acceptance of the draft audit report, and 15% upon acceptance and approval of the final audit report.

NOTE: Solicitation documents may, from time to time, be amended or addenda issued. It is the Proposers responsibility to become aware of any such amendments and/or addenda prior to submission of a proposal. All amendments and/or addenda to solicitations will be posted to this contract reporter notice.

MINIMUM QUALIFICATIONS TO PROPOSE :

  1. The bidder must be a NYS Small Business, NYS certified Service Disabled Veteran Owned Business, or a certified Minority-Owned or Women-Owned Business. The Bidder must supply proof of status as a certified New York State Service Disabled Veteran Owned Business, certified Minority-Owned or Women-Owned Business or provide attestation that your organization qualifies as a NYS Small Business entity as defined in Chapter 15 of the Economic development law, Section 131 (Article 4-B Division for Small Business).
  2. The bidder must be an independent Public Accounting firm that has a New York State (NYS) licensed Certified Public Accountant (CPA) on staff or an independent CPA licensed in NYS.
  3. The bidder must have at least three (3) years of experience working with healthcare reporting.

METHOD OF AWARD

DOH will evaluate each proposal based on the Best Value concept. This means that the proposal that best optimizes quality, cost, and efficiency among responsive and responsible offerors shall be selected for award (State Finance Law, Article 11, 163(1)(j)).

DOH at its sole discretion, will determine which proposal(s) best satisfies its requirements. DOH reserves all rights with respect to the award. All proposals deemed to be responsive to the requirements of this procurement will be evaluated and scored for technical qualities and cost. Proposals failing to meet the requirements of this document may be eliminated from consideration. The evaluation process will include separate technical and cost evaluations, and the result of each evaluation shall remain confidential until both evaluations have been completed and a selection of the winning proposal is made.

Contract term: The anticipated contract term will be for a one (1) year period commencing on January 1, 2018 or upon approval of the contract, whichever is later. It is the Departments intent to award one (1) contract from this procurement.

Proposal Due Date

To apply for this contracting opportunity, bidders must submit their proposal via email to OHIPContracts@health.ny.gov , and include Basic Health Program Audit in the subject line on or before November 2, 2017 at 4:00PM. All bids must be received by this date.

Questions

There will be an opportunity available for submission of written questions and requests for clarification with regard to this procurement. Any questions and requests for clarification must be submitted via email to OHIPContracts@health.ny.gov and include Questions Regarding Basic Health Program Audit in the subject line no later than October 16, 2017. Answers will be posted on or about October 20, 2017.

Due Date: 11/02/2017 4:00 PM

Contract Term: 1/1/2018-12/31/2018

Location: 99 Washington Avenue, Albany New York

Ad Type: Discretionary procurements between $50,000 and $200,000

Primary Contact: Health, NYS Dept. of
Office of Health Insurance Programs

John Neuberger
Senior Healthcare Systems Analyst
1 Commerce Plaza
Albany, NY 12210
United States
Ph: 518-408-5294
Fax:
john.neuberger@health.ny.gov
Secondary contact: Health, NYS Dept. of
Office of Health Insurance Programs

John Neuberger
Senior Healthcare Systems Analyst
1 Commerce Plaza
Albany, NY 12210
United States
Ph: 518-408-5294
Fax:
john.neuberger@health.ny.gov

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