Posted Date : November 11,2022
Product (RFP/RFQ/RFI/Solicitation/Tender/Bid Etc.) ID : MB-6930
Government Authority located in Mississippi; USA based organization looking for expert vendor for payment methodology services.
[A] Budget: Looking for Proposals
[B] Scope of Service:
(1) Vendor needs to provide payment methodology services for payment methodology support that will expire on June 30, 2023.
- Incumbent vendor, Conduent, to support and complete the state fiscal year 2024 rate changes effective July 1, 2023, for inpatient services, outpatient services, and other fee schedules and to support fiscal year-end reports for the Quality Incentive Payment Program (QIPP).
- Annual simulations including fee-for-service (FFS) claims and managed care encounters. The simulation presented each year should be developed based on recommendations from the contractor and policy direction discussions with DOM staff. The draft simulation will be due in March, and a final simulation will be due after
- Annual analysis of rate change financial impact by category of eligibility (COE) to be used by DOM’s actuaries for setting CCO capitation rates.
- Annual updates to the APR-DRG payment calculator (excel spreadsheet), FAQ, and quick tips posted on DOM’s website no later than July each year.
- Annual development and execution of provider trainings to explain rate changes no later than July each year.
- Recommendations for State Plan Amendments (SPAs) and Administrative Code changes as needed.
- Analysis including fee-for-service claims and managed care encounters
- Recommendations for how data issues should be handled in rate setting for the upcoming year
- Presentation of Look Back and recommendations to DOM staff
- Application of the agreed-upon data issue handling to the rate setting process
- Provide a report detailing the annual Centers for Medicare and Medicaid Services (CMS) inpatient prospective payment system (IPPS) proposed and final rules.
- Provide a report detailing an annual review of inpatient completion factors for fee-for-service and managed care encounter claims that will be performed and delivered.
(2) All the questions must be submitted no later than November 30, 2022
(3) Mandatory Letter of Intent must be submitted no later than November 30, 2022
[C] Eligibility:
- Onshore (US Only);
[D] Work Performance:
- Performance of the work will be Offsite.
Budget :
Deadline to Submit Proposals: January 06,2023
Cost to Download This RFP/RFQ/RFI/Solicitation/Tender/Bid Document : 5 US$
Product (RFP/RFQ/RFI/Solicitation/Tender/Bid Etc.) ID : MB-6930
Government Authority located in Mississippi; USA based organization looking for expert vendor for payment methodology services.
[A] Budget: Looking for Proposals
[B] Scope of Service:
(1) Vendor needs to provide payment methodology services for payment methodology support that will expire on June 30, 2023.
- Incumbent vendor, Conduent, to support and complete the state fiscal year 2024 rate changes effective July 1, 2023, for inpatient services, outpatient services, and other fee schedules and to support fiscal year-end reports for the Quality Incentive Payment Program (QIPP).
- Annual simulations including fee-for-service (FFS) claims and managed care encounters. The simulation presented each year should be developed based on recommendations from the contractor and policy direction discussions with DOM staff. The draft simulation will be due in March, and a final simulation will be due after
- Annual analysis of rate change financial impact by category of eligibility (COE) to be used by DOM’s actuaries for setting CCO capitation rates.
- Annual updates to the APR-DRG payment calculator (excel spreadsheet), FAQ, and quick tips posted on DOM’s website no later than July each year.
- Annual development and execution of provider trainings to explain rate changes no later than July each year.
- Recommendations for State Plan Amendments (SPAs) and Administrative Code changes as needed.
- Analysis including fee-for-service claims and managed care encounters
- Recommendations for how data issues should be handled in rate setting for the upcoming year
- Presentation of Look Back and recommendations to DOM staff
- Application of the agreed-upon data issue handling to the rate setting process
- Provide a report detailing the annual Centers for Medicare and Medicaid Services (CMS) inpatient prospective payment system (IPPS) proposed and final rules.
- Provide a report detailing an annual review of inpatient completion factors for fee-for-service and managed care encounter claims that will be performed and delivered.
(2) All the questions must be submitted no later than November 30, 2022
(3) Mandatory Letter of Intent must be submitted no later than November 30, 2022
[C] Eligibility:
- Onshore (US Only);
[D] Work Performance:
- Performance of the work will be Offsite.
Budget :
Deadline to Submit Proposals: January 06,2023
Cost to Download This RFP/RFQ/RFI/Solicitation/Tender/Bid Document : 5 US$