IE11 Not Supported

For optimal browsing, we recommend Chrome, Firefox or Safari browsers.

State Health-Care Entity Seeks Help Building Automated Solution

In a Request for Offer released late last week, the California Department of Health Care Services is seeking assistance with its California Automated Recovery Management “Digital Support Services.”

This story is limited to Industry Insider — California members.
This story is limited to Industry Insider — California members. Login below to read this story or learn about membership.
The state entity charged with delivering residents access to quality affordable health-care is seeking assistance from IT companies to create an automated solution.

In a Request for Offer (RFO) released Thursday, the California Department of Health Care Services (DHCS) calls for eligible companies with “a current IT Consulting Services, Master Contract with the Department of General Services (DGS)” to respond with “(California Automated Recovery Management) CalARM Digital Support Services.” CalARM is DHCS’ ongoing IT project to “implement an automated debt collection solution to improve and increase debt collection, manage third-party liability and recovery, and consolidate and streamline TPL and recovery business processes,” according to the California Department of Technology’s (CDT) Project Approval Lifecycle (PAL) tracking. DHCS is in Stage 3 of the PAL process; the RFO is being conducted under CDT policies and procedures. Among the takeaways:

  • DHCS is using a “continuous modernization approach” to update its Medicaid Management Information Systems, which use 40-year-old IT to deliver “partially automated support” for processes running the state’s fee-for-service Medicaid program. Since March, the department has been “in the process of procuring and contracting for a commercially available Cloud Software-as-a-Service (SaaS) solution” — CalARM — for “the automated identification, calculation, recovery, and reconciliation of Medi-Cal expenses,” according to the RFO. The solution eventually selected will need to “achieve the business needs for DHCS’ Third Party Liability and Recovery Division (TPLRD),” and replace legacy apps and manual processes.
  • Among the department’s general needs for CalARM, the solution must be “configurable and business rules-based” and deliver “self-service and real-time transactions” via a customer-facing online portal. CalARM must use “open standards/application programming interfaces (APIs)” to facilitate “data exchanges, interfaces, and integration with internal and external systems/entities.” It must “enable compliance with the Federal Centers for Medicare and Medicaid Services (CMS) guidelines and CMS System Certification,” and elevate the department’s Medicaid Information Technology Architecture (MITA) maturity level to Level 3.
  • The project will require roughly five key staff: an informatics data analyst to perform data conversion/migration; a technical architect; an interaction designer/user and researcher; usability user to serve as test lead; and a DevOps engineer. General mandatory experience requirements include at least three years’ experience “providing data conversion/migration support, technical architect support, testing support and DevOps support” to a business similar to DHCS in size and complexity; three years’ experience in “complex multi-system process assessments and identifying and assessing technical solutions to solve business needs or problems using modular solutions”; three years’ experience implementing and supporting Commercial-Off-the-Shelf (COTS) solutions in a SaaS cloud infrastructure; and at least two years’ experience implementing and supporting activities that ensure continued security compliance with the National Institute of Standards Technology, and Federal Information Processing Standards in COTS solutions in SaaS cloud infrastructure.
  • The department “intends to make a single contract award to the respondent that DHCS believes can best meet its needs based on the requirements identified within this RFO.” A precise contract value isn’t discussed, but the contract base term will be three years with the state reserving the option of up to three additional one-year extensions. Questions are due by Aug. 12, and responses will come Aug. 19. Offers are due by 3 p.m. Sept. 13 and will be evaluated Sept. 14-27. Negotiations, if needed, are slated for Oct. 1-14, with best and final offers due Oct. 21 if held. A notice of award is expected Oct. 27, and the proposed contract start date is Nov. 10.
Theo Douglas is Assistant Managing Editor of Industry Insider — California.