Only one company submitted a proposal to help the state decide what kind of system it needs for Medicaid claims processing and eligibility determination for the more than $7 billion government health insurance program for the poor, according to the Jindal administration.
State health agency officials are evaluating the proposal by First Data, of Atlanta, to provide what is described as “staff augmentation.” A decision on the contract award is expected to be reached by Oct. 17. No price has been determined.
Ruth Johnson, a special advisor for the State Division of Administration, said she was “shocked to hear” that only one firm sought the work. But, she added, “Right now across the country ... everybody’s got a project of some type going on.” Johnson said a lot of work is associated with preparations for implementation of the federal Affordable Care Act.
First Data is described as a global claims processing company.
The outside professional help is being sought as the Jindal administration prepares to seek a replacement for its fired Medicaid claims processor Client Network Services Inc. CNSI lost a nearly $200 million contract earlier this year because of alleged improprieties. The company is suing the state for wrongful contract termination.
Health Secretary Bruce Greenstein, a former CNSI executive, resigned as news broke of a federal investigation into the contract award.
A state grand jury probe also is underway.
If First Data gets the “staff augmentation” contract, the firm will also provide input on another system that verifies a person’s eligibility when they seek Medicaid coverage.
The hope is the two systems can be integrated to achieve savings, Johnson said.
“You would want the framework ... the same architecture to work” for both, she said.
The state does not have the level of expertise in-house to do the work. Johnson said technical knowledge as well as awareness of what kind of systems are in use in other states and changes in federal standards are all things a contractor would bring to the table.
The same type “staff augmentation” contract was entered into with Maximus in preparation for the last Medicaid claims processing contract solicitation which ended in CNSI getting the award. The $1.6 million contract ended in 2011.
The administration had been on a fast-track to get the extra help on the two big Medicaid technology systems. The original request for proposal had a Sept. 6 dates for firm selection and work scheduled to begin Sept. 23. Now, the state hopes to have the contract in place by Nov. 4, Johnson said.
A day or two before proposals were to be submitted, Johnson said the state altered the schedule to allow the state Department of Health and Hospitals to insert language to allow a whole, partial or no award as well as provide time for verbal interviews with potential candidates.
“You want X, Y, Z and then get the ticket and can only afford X and Y. So the state pulled back and rewrote to have options,” Johnson said.
Johnson said DHH is doing its evaluation of the First Data proposal. If it meets muster, then the Division’s Office of Contractural Review gets the proposal for more scrutiny by a special procurement support team, she said.
Part of the review is to make sure that the request for proposal or any addendum restricted in any way who could provide the services or if it was so restrictive that very few people could participate. The reviewwill also look at terms and conditions, she said.
The federal Centers for Medicare and Medicaid Services will also be consulted, Johnson said.
The decision on whether to rebid has not yet been made yet, Johnson said.
“We must go through the process of all those reviews,” Johnson said.