Deltek Pulse: June health care and human services recap

June brought a handful of procurement activity for the Women, Infants and Children (WIC) Program, and with the uptick in WIC-related procurements, Deltek released an industry report on electronic benefits transfer (EBT) technology for the WIC Program.

Deltek is tracking nearly 60 upcoming EBT opportunities – most of which are in states that are undecided on the type of WIC EBT solution they will implement (online or offline). Early EBT system implementations include cards with real-time online verification and cards with embedded chips that store benefits data offline. Consortia and pilots for portable solutions are also in play. Obtain a copy of the report here.

WIC-related procurement activity in June included:

• The New York State Department of Health (NYSDOH) released an RFP for the New York State Women, Infants and Children (WIC) Program Electronic Benefits Transfer (EBT) Analysis Project on June 17. The selected vendor for the project will assist NYSDOH in conducting an analysis to identify the readiness and options for converting from issuing paper checks to issuing EBT cards in the WIC Program.
• NYSDOH released another RFP for WIC banking services on June 19. The incumbent contract with Keycorp Inc. will expire March 31, 2014.
• The commonwealth of Massachusetts Executive Office of Health and Human Services, Department of Public Health, WIC Program, released a request for responses (RFR) for WIC EBT processor services on June 4. According to the implementation advanced planning document (IAPD), the Department of Public Health plans to spend approximately $1.25 million in development/rollout costs for WIC EBT, and $270,000 for the first year of operations. The department also plans on procuring for a quality assurance vendor.
• New Mexico concluded its proposal collection period for EBT services on June 25, and Georgia closed its proposal period for its WIC back end and banking system on June 28.13, enrollment deadline, we have seen a major decline in procurements for health insurance exchanges (HIXs) in the past few months, with the exception of procurements for HIX navigators and outreach and enrollment services. States that ceded to letting the federal government implement exchange technology in their state may soon begin to look to planning and consulting vendors to assist in assessing and planning the feasibility and desirability of bringing the exchange, or components of the exchange, in state in the future. Look for a report from Deltek this fall examining upcoming HIX procurement opportunities.

 Other notable health care and social services procurement activity included:

• The Colorado Department of Health Care Policy and Financing (HCPF) released a request for information (RFI) for improving Medicaid fraud detection. HCPF seeks information on state-of-the-art analytical tools and methods for pre-payment review of Medicaid claims to detect possible overpayments or fraud; identify rules and policies that should be revised to prevent possible waste, fraud or abuse; and profiling of providers to identify possible overpayments or fraud.
• The Colorado HCPF also released an RFP for Medicaid independent verification and validation (IV&V) services. HCPF continues to evaluate proposals received for the core MMIS functions and fiscal agent services solicitation, released in January 2013.
• Colorado’s Department of Human Services (CDHS), Division of Child Welfare Hotline Steering Committee (HSC), will work with an expert consultant to make recommendations for a child welfare abuse and neglect reporting hotline. DHS is currently reviewing proposals received for the consulting RFP, released June 18, 2013. Per House Bill (HB) 131271, HSC has been tasked with making a recommendation for the design, technology, capacity, workflow, staffing, and cost aspects of a hotline system by November 1, 2013.
• The Oklahoma Health Care Authority (OHCA) released an RFP for care coordination for Medicare/Medicaid dual eligible members on June 19. Figures from state fiscal year 2011 indicate that 105,538 people were eligible for SoonerCare, the state’s Medicaid program, and Medicare at the time.
• The New York State Department of Health released an RFP for Medicaid administrative services (MAS) on June 25. The selected contractor will administer the NYS fee-for-service Medicaid program as well as fiscal agent functions of its managed care program, and replace the current NYS MMIS with a new mechanized claims processing and information retrieval system.

Given the fast-approaching the October 1, 2013, enrollment deadline, we have seen a major decline in procurements for health insurance exchanges (HIXs) in the past few months, with the exception of procurements for HIX navigators and outreach and enrollment services. States that ceded to letting the federal government implement exchange technology in their state may soon begin to look to planning and consulting vendors to assist in assessing and planning the feasibility and desirability of bringing the exchange, or components of the exchange, in state in the future. Look for a report from Deltek this fall examining upcoming HIX procurement opportunities.

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