The Department of Health Care Services has provided more details for its Medi-Cal Program Integrity Data Analytics (MPIDA) program and extended the deadline for responses.
The due date for proposals is now Nov. 13 – it previously was Oct. 21.
“The contractor will provide services that will produce reports identifying suspicious cases to create an infrastructure that the DHCS investigators will use to create specific queries for detailed information on providers, beneficiaries and geospatial data, all with the intent of identifying which providers should be suspended, and to develop sufficient evidence to prosecute the most egregious offenders,” the department says.
The contractor will use predictive modeling techniques and create a “data mart,” build quarterly reports, install and maintain all software, hardware and the network. The project is slated to kick off in April 2016.
DHCS posted on Oct. 22 answers to more than 200 questions about the bid posed by potential bidders. Among the information provided, the department’s Medi-Cal Management Information System/Decision Support System (MIS/DSS) data warehouse contains about 46 terabytes for 10 years’ worth of structured and unstructured data.
HCS also said it’s not dictating a hosting solution: The proposed solution could be located in the state data center, the contractor’s data center or the cloud.
DHCS also provided more data about the volume of claims:
“For 2014 we had about 310 million claims header records (170 million are managed care encounters, 115 million various FFS claims and 25 million dental), 450 million claim detail records (each claims header record has one or more detailed records), 50 million denied records. The current beneficiary file has 66 million records, the current monthly eligibility file has 1.2 billion records and the current provider file has over 700,000 records, less than half of which may currently be active.”
The contract is capped at a maximum of $10 million per year and a duration of up to five years, according to the bid document. There is no amount limit on the bid’s “optional” services, which will be added at the discretion of DHCS.
