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

The Commonwealth of Kentucky, through the 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 contract aims to support approximately 15,640 participants by providing essential services including electronic visit verification, claims processing, payroll, tax assistance, and financial reporting. The anticipated start date for the services is February 1, 2027, following a proposal deadline of November 6, 2026. The vendor is required to adhere to strict technical and security standards, including integration with the Kentucky Online Gateway (KOG) for identity and access management and compliance with Commonwealth Office of Technology (COT) requirements. Data security is paramount, with mandates for HIPAA compliance via a Business Associate Agreement and strict adherence to IRS Publication 1075 for handling Federal Tax Information. Performance is monitored through pre-operational and operational report cards, with specific monetary penalties ranging from $100 to $10,000 for non-compliance regarding call center support, billing accuracy, and disaster recovery. Personnel requirements are rigorous, necessitating background checks, vetting by the agency, and professional liability insurance of at least $1 million per claim. The contract emphasizes a structured project management approach following PMI best practices, with key deliverables such as a Project Charter, Work Plan, and Quality Management Plan. All Commonwealth data must remain within the contiguous United States, and the vendor must maintain a high level of financial integrity and accountability to ensure the quality of care and cost neutrality of the waiver programs.