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INDIANA DEPARTMENT OF ADMINISTRATION

Prior Authorization & Utilization Management Services REQUEST FOR PROPOSAL 13-78 on behalf of Office of Medicaid Policy and Planning. INDIANA DEPARTMENT OF ADMINISTRATION. GENERAL INFORMATION Attendee Sign-In Sheet Sign-In Sheet and PowerPoint will be posted on State’s Solicitation Website.

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INDIANA DEPARTMENT OF ADMINISTRATION

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  1. Prior Authorization & Utilization Management ServicesREQUEST FOR PROPOSAL 13-78on behalf ofOffice of Medicaid Policy and Planning INDIANA DEPARTMENT OF ADMINISTRATION

  2. GENERAL INFORMATION • Attendee Sign-In Sheet • Sign-In Sheet and PowerPoint will be posted on State’s Solicitation Website INDIANA DEPARTMENT OF ADMINISTRATION

  3. RFP QUESTIONS AND ANSWERS • Questions answered verbally today are not official nor binding and should be submitted in writing if it will affect your proposal response (Q/A Template – Attachment I) • All questions must be submitted in writing by 3:00 PM EST on April 19, 2013 • Email: MAROBINSON@idoa.in.gov • Fax: 317.232.7312 INDIANA DEPARTMENT OF ADMINISTRATION

  4. ACCESSING RFP DOCUMENTS www.in.gov/idoa/proc INDIANA DEPARTMENT OF ADMINISTRATION

  5. ACCESSING RFP Documents INDIANA DEPARTMENT OF ADMINISTRATION

  6. KEY RFP DATES INDIANA DEPARTMENT OF ADMINISTRATION

  7. PURPOSE AND SCOPE OF RFP 13-78 The purpose of this RFP is to select a vendor that can satisfy the State’s need for Prior Authorization and Utilization Management services for IHCP enrollees excluding those enrolled in the managed care portion of the program. The PA function shall cover all products and services for which the State’s medical policy requires PA, except pharmacy services. Contractor will receive PA requests from providers via telephone, fax, web-based system or in writing and will process them in a timely manner, including interfacing with IndianaAIM. As part of the PA services, Contractor shall set up a PA call center and have in place other technologies such as faxes and web-based systems to accept PAs. Additionally, Contractor will be responsible for providing Utilization Management services, which include Reviews for Elective Inpatient Admissions, Traumatic Brain Injury Services, Peer Review Studies and Focused Studies. INDIANA DEPARTMENT OF ADMINISTRATION

  8. RFP OUTLINE INDIANA DEPARTMENT OF ADMINISTRATION

  9. BUSINESS PROPOSAL • Company Financial Information (Section 2.3.3) • Confidential information must be kept separate from the proposal in both hard and soft copy INDIANA DEPARTMENT OF ADMINISTRATION

  10. COST PROPOSAL The cost proposal is comprised of sections for Prior Authorization, Utilization Management and Implementation respectively. INDIANA DEPARTMENT OF ADMINISTRATION

  11. COST PROPOSAL (Cont.) The cost proposal is comprised of sections for Prior Authorization, Utilization Management and Implementation respectively. INDIANA DEPARTMENT OF ADMINISTRATION

  12. MINORITY AND WOMEN’S BUSINESS ENTERPRISE Complete Attachment A, MWBE Form - Include sub-contractor letters of commitment Goals for this RFP: - 8% Minority Business Enterprise - 8% Women’s Business Enterprise INDIANA DEPARTMENT OF ADMINISTRATION

  13. MINORITY AND WOMEN’S BUSINESS ENTERPRISE $$$$$$ INDIANA DEPARTMENT OF ADMINISTRATION

  14. INDIANA ECONOMIC IMPACT The State defines FTE as a measurement of an employee's productivity on a specific project or contract. A FTE of 1 would mean that there is one (1) worker fully engaged on a project; forty (40) hours a week, fifty-two (52) weeks a year. If there are two (2) employees each spending 1/2 of their working time, 20 hours per week, on a project that would also equal 1 . $$$$$$ INDIANA DEPARTMENT OF ADMINISTRATION

  15. RFP SCORING AND EVALUATION INDIANA DEPARTMENT OF ADMINISTRATION

  16. QUESTIONS AND ANSWERS INDIANA DEPARTMENT OF ADMINISTRATION

  17. ADDITIONAL INFORMATION IDOA PROCUREMENT LINKS AND NUMBERS http://www.in.gov/idoa/2354.htm 1-877-77BUYIN (8946) For Vendor Registration Questions http://www.in.gov/idoa/2464.htm For Inquiries Regarding Substantial Indiana Economic Impact Link to the developing “one stop shop” for vendor registry with IDOA and Secretary of State. http://www.in.gov/idoa/2467.htm Secretary of State of Indiana: Can be reached at (317) 232-6576 for registration assistance. www.in.gov/sos Vendor Handbook: Online version available at http://www.in.gov/idoa/files/vendor_handbook.doc Minority and Women Owned Business Enterprises: http://www.in.gov/idoa/files/Certification_List(48).xls for table of IDOA certified MBEs and WBEs. For more WBE’s information http://www.in.gov/idoa/2352.htm RFP posting and updates: Go to http://www.in.gov/idoa/2354.htm (select “State of Indiana Opportunities” link) Drag through table until you find desired RFP/RFI number on left-hand side and click the link. INDIANA DEPARTMENT OF ADMINISTRATION

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