RFP-746-2500000254-3 | Financial Mgmt. for PDS in 1915(c)HCBS Waiver Programs C5684

The Commonwealth of Kentucky Cabinet for Health and Family Services, Department for Medicaid Services, is soliciting proposals for Financial Management Services (FMS) to support Participant-Directed Services (PDS) across five 1915(c) Medicaid waiver programs: Acquired Brain Injury, ABI Long Term Care, Home and Community Based, Michelle P. Waiver, and Supports for Community Living. The selected vendor will provide comprehensive financial operations for approximately 15,640 participants, including payroll processing at least twice per month, electronic visit verification, claims processing, tax assistance, and detailed financial reporting. The anticipated contract start date is February 1, 2027, with proposals due by November 6, 2026. Technical requirements mandate integration with the Kentucky Online Gateway for identity and access management using SAML 2.0, OIDC/OAuth 2.0, or WS-Fed protocols. Vendors must comply with Commonwealth Office of Technology standards, including FedRAMP/HITRUST certification for cloud platforms and strict data residency within the contiguous United States. Security is paramount, requiring a Business Associate Agreement for HIPAA compliance and immediate notification of data breaches within 30 minutes. The contract includes a rigorous performance monitoring system utilizing pre-operational and operational report cards, with monetary penalties ranging from $100 to $10,000 for non-compliance in areas such as call center support, billing accuracy, and disaster recovery. Evaluation is based on a point system consisting of a technical proposal (800 points), a cost proposal (300 points), and potential oral demonstrations (200 points). Technical qualification requires proof of being a licensed entity for at least five years and the ability to maintain staffing levels at 90 percent or more of the agreed-upon plan. Cost proposals must specify a rate per member per month and a monthly administrative cost, noting that travel and training expenses are not reimbursable. Additionally, the contractor must maintain cyber insurance or a performance bond for the full contract amount to cover liabilities related to cybersecurity breaches and data loss.