RFP for Asset Verification Services to Enhance Medicaid Eligibility Integrity

The contract involves the provision of an Asset Verification System (AVS) solution designed to enhance Medicaid eligibility integrity for the Aged, Blind, and Disabled (ABD) population in North Carolina. The system aims to identify and verify financial assets to reduce fraud, waste, and abuse by establishing a network of financial institutions, tracking and reporting asset information, and supporting timely, accurate verification processes. The solution must comply with federal and state regulations, including the Social Security Act, HIPAA, and Gramm-Leach Bliley Act, and incorporate robust security measures such as annual third-party security assessments, encryption, and access controls to safeguard Protected Health Information and Personally Identifiable Information. The contract emphasizes system reliability, with a minimum uptime of 98%, and requires comprehensive reporting, operational support, and system maintenance, including upgrades, patches, and incident management. The procurement is structured as a three-year contract with the possibility of two additional one-year extensions, with an estimated value ranging from five to fifteen million dollars. Vendors must submit detailed technical, management, cost, and certification proposals through an online electronic sourcing platform, adhering strictly to submission instructions. The evaluation process will prioritize technical capability, experience, cost, and overall value, using a trade-off/ranking method that balances price and non-price factors. The contract stipulates rigorous compliance with privacy, security, and legal certifications, including state and federal certifications, business associate agreements, and attestations of lawful employment practices. Additionally, the vendor is responsible for establishing contingency plans, maintaining key personnel dedicated to the project, and providing ongoing support, training, and documentation to ensure seamless integration and operation of the AVS within North Carolina’s Medicaid infrastructure.