STATE OF NEW YORK
BIDDERS' CONFERENCE
July 14, 2010, 10:30 a.m.
REPLACEMENT MEDICAID MANAGEMENT INFORMATION SYSTEM
(R-MMIS) Fiscal Agent Services Project
Request For Proposal (RFP)
Wednesday, July 14, 2010
10:30 a.m.
Empire State Plaza
Conference Room 1
Albany, New York
SPEAKERS:
TOM DONOVAN, Medicaid CIO
HENRY STONE, Division of Systems
Administrative Support Director
DENNIS McFADDEN, eMedNY Director
JONATHAN MAHAR, Bureau of Accounts Management
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MR. DONOVAN:
Good morning.
Thanks for
2
coming.
3
remarks.
4
we'd appreciate that, if you haven't already.
5
did, right?
6
out front.
7
drop them off, that would be great.
8
9
A little housekeeping before I get into my
If you could turn off your cell phones,
Nobody
I hope you all provided business cards
If you haven't, on your way out, if you'd
You should know that the responses we give
here to questions, verbal responses, are not binding.
10
However, your written questions submitted to us will
11
be responded to and posted on the Department's
12
website, and they will be binding.
13
I appreciate you coming.
Thanks.
It's been
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a while to get this party together.
We're finally
15
there.
We've been working at this for too long,
16
right?
And you've been waiting for too long, so
17
that's good.
18
effort.
19
capability and our overall management of the program
20
through this particular effort.
21
we've offered you to look at is a significant -- in
22
some respects a significant departure from the
23
traditional MMIS project.
24
careful to fashion our requirements around the
25
Medicaid Information Technical Architecture,
For us it's a pretty significant
We are hoping to enhance claims processing
We think that what
And we've been very
3
1
otherwise known as MITA, which suggests a maturity
2
growth over the period of a contract and suggests
3
general directions that we'll be going in an agency.
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Just let me give you a couple of statistics
5
about the program you may know; you may not know.
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But we process approximately $47 billion plus a year
7
through the system.
8
it's the largest in the country.
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we process about 12 claims a second on a 7/24/365
From a financial perspective
10
basis.
11
approximately one third of the healthcare
12
expenditures in the State of New York, so this is a
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significant influx of dollars into the New York State
14
economy.
15
those terms, but it is.
16
economic driver in the State's GDP.
17
It's a lot of money.
For claims volume
We represent
People tend not to think of Medicaid in
It is a very significant
And last but not least, we ensure
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approximately 21 percent, give or take, of the
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State's population, over 4 million insured, second to
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California; they are about 7 million insured.
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big program, significant challenges.
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excited about this engagement and, as I said, it's
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been a long time coming.
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We're glad you're here.
your responses.
It's a
We're very
We look forward to
And with that I'm going to turn it
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1
over to Henry Stone, who will walk you through some
2
of the timetables, and then we'll move through the
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agenda.
4
5
Thanks very much.
MR. STONE:
Pat, you want to put up the
power point, second slide?
6
I'm Henry Stone.
I'm the logistics manager
7
for this.
8
the RFP put together and on the website, and I just
9
want to run you through quickly with the critical
10
11
I'm the one who is responsible for getting
dates.
A week from tomorrow, which is July 22nd,
12
all questions are due in.
I suggest whatever you
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have, verbalize it, get it in early so we can respond
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to the concerns you have.
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have is sometimes vendors who aren't used to the New
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York State process will have a normal corporate
17
header or footer that says "this is proprietary or
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confidential information."
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all responses on the website, if you do that, we're
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going to have to go to our lawyers, our FOIL
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attorney, and say "what can we do," which may delay
22
answering your question.
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questions thrown out.
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question, please, do not qualify it with saying
25
anything about confidentiality or proprietary.
One of the concerns we
Since we plan to put up
It may even have your
So when you send in a
If
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there's something that's really proprietary, it
2
probably is not germane to be asking a question about
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it at this point.
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We intend to respond to all questions and
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have them up on the website right around August 12th.
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It may be the 12th or 13th, but it will be about --
7
on or about August 12th.
8
9
And then, finally, once you see them, do
your proposals.
Proposals are due in October 29th at
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1:00 p.m.
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them, whatever, make sure you leave enough time so
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they can get from the mail room up to the room that
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we have in the RFP.
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by hand, you all probably have dealt with the
15
security in various state buildings.
16
have enough time to get yourself through the security
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to get them upstairs.
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If you're going to mail them in, Fed Ex
If you're going to bring them in
Make sure you
And good luck to all of you, and we look
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forward to looking at your proposals.
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Mr. McFadden will now go through the highlights of
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the RFP.
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MR. McFADDEN:
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Good morning, everyone.
And
Thank you Henry, Tom.
What we have here
24
is -- we had 14 slides, but it won't take us too
25
long.
Henry usurped two of them for me.
What we
6
1
have are an entire RFP and system summarized in 12
2
slides.
3
overview.
4
I'm sure all of you are aware now that everything is
5
available in the RFP which was released on June 4th,
6
and it's available on the website for anyone who
7
might not be aware of that, the DOH website,
8
NYhealth.gov.
9
As Henry said, it's a very, very high level
I'd say a mile high version.
Of course,
The objectives, what we're looking for, we
10
want to have implemented a federally certifiable
11
R-MMIS, replacement MMIS, that includes all the
12
functionality of the current system.
13
alluding to some of that functionality.
14
rather large system.
15
in case you haven't heard of it.
16
current functionality, we're also looking to enhance
17
the functionality in many, many areas, three of which
18
are outlined on there, provider services, pharmacy
19
benefit management, and dental claim and prior
20
approval processing.
And Tom was
It's a
The system is known as eMedNY,
In addition to the
21
The new system, of course has to be able to
22
work with the new HIPPA version 5010 and NCPDPD.0 EDI
23
standards.
We're working on those now.
24
compliant.
Probably that project will be implemented
25
sometime late next summer.
We will be
It's required to be in
7
1
2
place by January 1, 2012.
In addition to 5010 we have to be ready to
3
work with the ICD-10, the International
4
Classification of Diseases 10 coding system.
5
where the ICD-9 will be going away -- let me say that
6
with a qualification -- on October 1 of 2013, but
7
that's the date of service, so anything prior to that
8
date still has to come in in ICD-9.
9
that date in ICD-10, which means that the new system
That's
Anything after
10
will have to be able to work with both types of
11
transactions, because we sometimes process claims
12
that are two years old, so we'll be looking at ICD-9
13
claims up until 2015 sometime.
14
four major bullets there will be in functional Phase
15
I, which we will get into the phases in a little bit
16
in a little more detail.
17
phases will employ the deployment of a COTS financial
18
management system, and we also are going to be
19
looking to raise our MITA standards to maturity level
20
3, at least.
21
architecture is going to have to be very flexible,
22
and that will be functional Phase III that we'll get
23
into here.
24
25
Those -- the first
The other two functional
So the information technology
On the next slide we outline those phases
that I just mentioned.
Of course, we're going to start
8
1
with Plan A, and then, as you can see, the three
2
implementation phases that I just alluded to followed
3
by certification, very, very important phase.
4
know what that one is.
5
system and operational enhancement phase, and then
6
followed by the turnover phase, the very last phase
7
when the contract is up.
8
exception, I think, all overlapping.
9
one right after the other concurrent.
We all
The operations phase and the
These phases are with one
They're not just
As a matter of
10
fact, the operations phase and the enhancement phases
11
run concurrently.
12
to the very last thing, anticipated schedule on the
13
last slide.
14
That will become apparent as we get
The planning phase.
We want to develop and
15
put into practice a series of plans mentioned here,
16
and they're not all mentioned here, I might add.
17
These are the major ones.
18
support all project phases with these things, these
19
plans that we come up with during the planning phase.
20
We want to ensure that the project maintains a high
21
quality of products and deliverables, stays in
22
schedule and within budget, so we're going to have a
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project management plan which includes all major
24
sections in the rather voluminous RFP.
25
We want to be able to
We'll have a risk management plan.
I'm
9
1
sure we're all familiar with what that is,
2
identifying risks, assessing them, mitigating them.
3
Scope management plan.
We want to make sure
4
we're doing all the work required but only the work
5
required.
6
Configuration management plan, that's your
7
software version control, hardware version control,
8
the documentation of everything.
9
There will also be some other plans that are
10
mentioned, such as quality management plan, but
11
you'll have to look at the RFP to get those.
12
All these plans will be based on the
13
offeree's proposed project management and their
14
system development life cycle methodology, which is
15
another thing we want to see spelled out as you see
16
when you delve in the RFP.
17
The implementation phases, there are three
18
of them.
19
all three implementation phases.
20
traceability and validation, we want to make sure
21
that all our requirements are correct, complete and
22
consistent.
23
many JAD sessions we anticipate.
24
25
These requirements listed here cut across
Requirements
This will be done primarily during many,
System design and development speaks for
itself.
Testing does, too.
That runs the gamut from
10
1
unit subtesting right through stress repression --
2
regression, excuse me, not repression -- Freudian
3
slip there -- regression testing and, of course,
4
parallel testing prior to implementation.
5
Organizational change management.
That's --
6
we're going to -- there will be many, many changes as
7
a result of this new system.
8
impact on staff, on DOH staff, on stakeholder
9
staffing.
10
We want to assess their
We want to be able to anticipate what
these changes will bring and how to manage them.
11
Data conversion, just in the first phase,
12
when we are preparing for operations, that's
13
self-evident, too.
14
Operational readiness.
That will require
15
the completion of a formal operational readiness
16
review.
17
here, will be sprinkled through all these various
18
stages and, of course, implementation.
19
be -- all of these again will also include incumbent
20
transition support.
21
with the DOH staff and also with the incumbent eMedNY
22
contract as well as with the data warehouse
23
contractor and our QA contractors.
24
25
We will have training, which I didn't list
That will
You're going to have to work
The next slide shows implementation of
functional Phase I.
When this phase is done, we will
11
1
commence operations.
2
DDI for the federally certifiable R-MMIS that I
3
mentioned.
4
requirements, has to include all functionality,
5
including the 24/7/365, which I believe we're unique
6
in the nation with that requirement that Tom
7
mentioned, and 1.7 million transactions daily on the
8
average.
9
And this phase consists of the
It has to meet all federal and state
It might be a little lower on Christmas.
Enhanced provider pharmacy benefit
10
management where we have to manage all our various
11
drug programs, preferred drug program, the clinic
12
drug program, mandatory generic program, the rebates
13
and everything, and also, as we alluded to before,
14
the 5010 standards and the ICD-10.
15
The second implementation phase is kind of
16
an empty slide there that consists entirely of the
17
development of and implementation of a COTS financial
18
management system.
19
management systems that work together, one develops
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eMedNY and the New York State Central Accounting
21
System, and, as a result, there are certain
22
inefficiencies that we would like to eliminate.
23
the processing, reporting, and recording of financial
24
transactions.
25
improve operations and reengineer these processes
Right now we have two financial
And
We would like to implement software to
12
1
using a COTS solution to the extent possible.
2
realize with the complexities involved here the COTS
3
might not entirely cover all our needs, so we will
4
accept an integrated solution of some sort with our
5
prior approval, of course.
6
management system consists of exactly what you would
7
expect, a general ledger, accounts payable and
8
accounts receivable, as well as contracts management.
9
We
And the financial
Functional Phase III, this is what I
10
mentioned previously.
11
contract the Department expects that in all business
12
areas we will at the end of this contract be at least
13
at MITA maturity level 3.
14
familiar with MITA maturity levels.
15
there's 1 through 5 of them.
16
few areas right now, but mostly we're in 1 and 2, but
17
we intend to be at 3.
18
MMIS must provide a unified technical application
19
architecture that's very, very flexible and capable
20
of supporting these changes.
21
Over the course of this
I'm sure most of you are
I believe
We might be at 3 in a
Therefore, the replacement
The next phase, certification, as I
22
mentioned, without federal certification we would be
23
in deep financial trouble, so we insist upon a
24
federally certifiable MMIS that meets all CMS
25
requirements, which are listed for your reading
13
1
2
pleasure in the RFP.
There is a -- the review schedule itself
3
will not be determined by the Department, of course.
4
That's going to be determined by CMS.
5
out for a nice long visit and test everything and
6
check everything out for us.
7
saw fit to mention here again, to stress that this
8
contractor who wins this bid will have to work with
9
the MDW contractor for the certification effort,
They will come
And during this we also
10
because there are a lot of overlapping
11
functionalities.
12
utilization review, for example, are three of them
13
that have overlapping functionalities.
14
that not only for the certification effort but
15
throughout the life of this contract you'll be
16
working very closely with the MDW contractor because,
17
of course, the R-MMIS is the primary source of data
18
for the MDW, so the hip bone is connected to the leg
19
bone, and any change that we make is going to be felt
20
there, so it's going to be a very close relationship
21
throughout.
22
MARS/SURS and retro drug
I might add
After the certification phase -- actually,
23
during it -- this is another one of the overlapping
24
phases we talked about -- comes the operations phase.
25
Don't switch yet, Pat, but the next slide shows the
14
1
system operational enhancement phase.
2
two concurrent phases that I mentioned.
3
run hand in hand.
4
that is.
5
new federally certified system to make sure that our
6
transactions are processed, providers get paid and
7
reports get produced in an accurate and timely
8
manner.
9
These are the
These will
And operations, we all know what
That simply consists of operating the brand
The enhancement phase, you notice that we
10
mention two different kinds of testing, maintenance
11
and enhancement.
12
which are well defined in the RFP, so I won't get
13
into any billing ramifications at this point; it
14
wouldn't be appropriate.
15
need an architecture that's flexible enough to
16
support a rapidly changing environment, because
17
that's what we have in MMIS.
18
initiating new initiatives, whether from a federal or
19
state mandate.
20
be rather large, to work from program and policy
21
changes.
22
and we have to have the system accommodate that
23
better way.
24
technologies, we are constantly changing.
25
be flexible, and we have to change rapidly.
Those are two very distinct tasks
But suffice to say that we
We're constantly
5010 is a great example, and it can
We figure out a better way to do business,
Just program growth through emerging
It has to
15
1
Finally, the turnover phase.
This will be
2
some of us will still be around to see that.
3
sure Mr. Donovan might.
4
whoever is taking over that system, whether it's a
5
successor contractor or the Department.
6
strong suspicion which of those two it will be, but
7
I'm not going to mention it.
8
9
I'm
You'll work closely with
And I have a
Next slide and last slide is the budget
timeline.
You can see how the phases overlap, as I
10
mentioned.
We're on the top.
MDW on the bottom.
11
The only ones that are not overlapping, as you can
12
see, are the functional Phase I, when you develop the
13
DDI of the current system with some enhancements and
14
the operations and enhancement phases.
15
that we expect a contract to be awarded -- contract
16
to begin, I should say, not be awarded, in March of
17
next year.
18
an 8-year contract with a three-year -- approximately
19
three-year DDI phase, because we expect operations to
20
begin in February of 2014.
21
specifically when parallel processing should begin a
22
few months before the takeover and the ICD-10 in
23
October 2013, but, again, we'll have to be able to
24
work with the ICD-9 transactions for a long time
25
after that.
You can see
It runs through February of 2019.
That's
We mention on here
And the certification, as you can see,
16
1
which will begin September of 2014, a few months
2
after implementation.
3
the MDW timeline, too, for the reasons I've already
4
spoken about.
5
6
7
You notice that's reflected on
That's a very high level overview, and I'm
going to turn it over to Jonathan Mahar.
MR. MAHAR:
Good morning.
My name is John
8
Mahar, and I'm from the Bureau of Accounts Management
9
at Department of Health, and I just wanted to take a
10
few minutes very briefly to go over some guidelines
11
regarding New York State lobbying law.
12
of the lobbying law is to increase disclosure
13
requirements for persons and organizations contacting
14
state government and to enhance public confidence in
15
the state's procurement process regarding lobbying
16
efforts of those seeking state contracts.
17
The purpose
The New York State lobbying information can
18
be found in the published RFP that you're all
19
familiar with, pages 15 and 16 under Roman numeral V,
20
I believe it's section J, letter J.
21
important reference to remember.
22
It's an
The lobbying laws become the ground rules
23
for much of our state procurement.
Among other
24
things, they give us rules to follow.
25
created a mechanism to publish lobbying law
They've
17
1
violators, and they have also established an advisory
2
counsel on procurement lobbying.
3
The law establishes a restricted period, and
4
I think this is the most important point to take home
5
today for all procurements.
6
this RFP when it was published on the DOH website on
7
June 4th of this year, and it will continue until
8
it's awarded by New York State controller and it's
9
actually an executed contract.
This period began for
During that
10
restricted period all of the comments and questions
11
and correspondence that you have must funnel through
12
staff that are designated by DOH.
13
designated in the RFP in several places.
14
types of contacts that you would be funneling this
15
information through.
16
This is the person who many communications that are
17
directed with the attempt to influence procurement
18
have to go to.
19
matter contact.
20
matter pertinent to the procurement are directed.
21
These would include technical logistical issues
22
regarding the RFP.
23
the beginning of the RFP and on the website right on
24
the home page for your information.
25
These are
There's two
There's the designated contact.
The other is the permissible subject
These are the persons that subject
All these contacts are listed in
So, in summary, I think the take-away is
18
1
that any contact that you have with DOH regarding
2
this procurement, this RFP, must go through the
3
official contacts that we've listed in the RFP.
4
Okay?
5
I'll turn it back over to Tom for questions.
6
MR. DONOVAN:
7
Questions?
8
the same?
9
Okay, don't be shy.
Why are all these business conferences
Nobody wants to go first.
Identify yourself and your firm.
10
MR. KEENE:
I'm Daniel Keene from Deloitte
11
Consulting.
12
R-MMIS COTS implementation of a financial management
13
solution.
14
financial system implementation for the comptroller
15
and the Governor's office, and I was wondering why
16
that was not recognized in the RFP in terms of -- is
17
it an integration that the DOH is looking for with
18
the new state-wide financial system?
19
mentioned CAS, the current system, but it's being
20
replaced as of April 2011, so I was wondering what
21
the thought around that was.
22
I had a question around the Phase II
I'm currently working on the state-wide
MR. DONOVAN:
I noticed you
Okay, good question.
Really,
23
there's two types of payments, direct payments to
24
providers, which would go through this mechanicism,
25
does not go through the controller's office, and
19
1
there are offline payments, inter-agency transfers
2
that we think would be better facilitated with an
3
interface of some sort, which we didn't define,
4
between us and the comptroller, as they are bringing
5
up a commercial package, as you know.
6
fairly arduous internal DOH process at this point to
7
do an awful lot of payments.
8
it's not integrated, as you know, with the
9
controller's office, so that's the thought behind it.
10
MR. KEENE:
11
MR. DONOVAN:
12
13
Right.
Yeah.
So it's a
It's not augmented, and
Can I ask a follow-up?
You got to go back up
there, though.
MR. KEENE:
Thanks for the answer, Tom.
I
14
understand that completely.
15
asked for a COTS solution for a financial management
16
solution that I would assume would run your
17
financials for the Department of Health.
18
would not?
19
20
MR. STONE:
No.
I'm just wondering, you
No, it
The financial solution we
ask for is strictly for the contractor.
21
MR. KEENE:
Okay.
22
MR. STONE:
We just felt we needed the
23
functionality that a full enterprise MMIS would give,
24
and it would provide an opportunity for easier,
25
simpler interfaces.
20
1
MR. DONOVAN:
Just to be clear, it's not the
2
financials for DOH; it's for the Medicaid program,
3
some of which are offline payments, as I mentioned,
4
that funnel through DOH administration, so there is
5
that spillover.
6
Medicaid program.
7
think it's a good idea to write GLs anymore.
8
point.
9
But it's principally for the
In addition, you know, we don't
MR. KEENE:
10
MR. DWORMAN:
So good
Thank you very much.
Good morning.
I'm Dennis
11
Dworman with HP.
12
have to go the down and up again.
13
ePrescribing -- the State has implemented and you
14
prescribing -- the Department has -- there's really
15
not much in the RFP about -- I'm wondering if you can
16
describe what the current incumbent responsibilities
17
are around ePrescribing and then go into the vision
18
of, if any, of what the new contractor will be asked
19
to do around ePrescribe.
20
Two quick questions, so we don't
MR. DONOVAN:
One is
ePrescribing was just recently
21
implemented, and it's really a payment methodology
22
approach.
23
prescription travels electronically from prescriber
24
to dispenser.
25
financial incentive to adopt ePrescribing, and that's
It's not that we're managing -- the actual
So what we've implemented is a
21
1
as far as we've gone.
2
3
MR. DWORMAN:
That's the context.
That's expected to continue in
that sa me fashion?
4
MR. DONOVAN:
Yes, it is.
I'm sorry.
No.
5
We're not certain right now, if the sun set in two
6
years -- they're going to take another look back
7
probably in a year or so and see where we are
8
financially and see what's working and what's not.
9
MR. DWORMAN:
Okay, thank you.
The second
10
question is there's mention of parallel tests and
11
parallel operations within the RFP and within
12
Appendix J.
13
they were the same thing or are they different
14
things, and if you could clarify that, that would be
15
helpful.
It was not perfectly clear to me that
16
MR. DONOVAN:
Give me that again.
17
MR. DWORMAN:
There's mention in the RFP of
18
a parallel test phase with a lot of requirements
19
around that.
20
parallel operations that I think are primarily in
21
Appendix J, and it's not clear whether those are the
22
same set of activities just with different names, but
23
I thought it would be helpful if we understood that a
24
little better.
25
There's also some mentions about
MR. DONOVAN:
We'll clarify that for the
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record, of course, but my sense is that what we want
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to do is an end-to-end type of parallel operation.
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You know, what you go through is various steps in
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testing, bring it up, do some regression, put some
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volume on it, but also there's a lot of manual moving
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parts in this that what we would like to see is a
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true end-to-end.
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MR. DWORMAN:
Great.
Thank you very much.
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MR. DONOVAN:
You're welcome.
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MR. GUARINO:
Good morning.
Ray Guarino
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with Magellan.
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period.
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question period?
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going to be a lot of questions from the vendors, some
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of which may generate other important questions back,
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so I was wondering in a procurement this large if you
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would consider opening it up for a follow-up Q&A
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period?
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A general question about the Q&A
Would the State entertain an additional
I would suspect that there are
MR. DONOVAN:
No.
What we'll do is we'll
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look at the traffic on -- the inbound traffic and see
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what the volume looks like and how we can manage it,
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frankly, and respond to you.
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generate a lot of secondary questions, we may
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consider it at that point, but right now going in
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we'll leave it where it is.
If that seems to
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MR. GUARINO:
questions.
Thank you.
A couple of other
In Roman numeral III, page 155 --
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MR. DONOVAN:
I know that.
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MR. GUARINO:
Paragraph M.2 is the slide.
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MR. DONOVAN:
This guy is killing me.
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MR. GUARINO:
Is the classification of
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contractor staff, talking about key in core staff,
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the requirement, as we understand it, is that all key
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staff have to be available upon contract startup.
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Just, one, I wanted to verify there are a number of
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positions, at least in our mind, that don't appear to
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us to be necessary right at the beginning of the
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contract but would make more sense to be brought in
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during the DDI period at some point.
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discussion about the State approving the vendor's
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staffing model, et cetera, but have you put any
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additional thought or would you give some
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consideration to not mandating all of those positions
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to be required at contract signing or contract start,
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rather have them available as needed during the DDI
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period?
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MR. DONOVAN:
I know there's
We like to stand pat on the
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core staff at this point -- key staff, rather.
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feel free to express your opinions in the
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question-and-answer period.
But
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MR. GUARINO:
Okay.
And then just a
follow-up question, same section on the core staff.
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MR. DONOVAN:
Is this M.2?
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MR. GUARINO:
Yeah, it was.
On the core
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staff, if core staff was required to be there at
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contract inception or, again, are they -- are the
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vendors at liberty to make a determination of when --
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the appropriate time to bring the core staff on?
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MR. DONOVAN:
I would say that you're not at
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liberty to stray from the requirements that are in
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the bid.
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like to raise in this period, we're happy to take a
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look at that.
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Again, if you have some suggestions you'd
MR. GUARINO:
I would just suggest the core
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staff requirements weren't clear.
Maybe if you could
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clarify whether those are also required to be in at
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contract inception.
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MR. DONOVAN:
Fine.
Submit your question.
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MR. GUARINO:
Thank you.
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MR. DONOVAN:
While you're thinking of your
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questions, one more comment.
You should know, this
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note here, that we will be posting the names of the
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individuals and the firms that attended this on the
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website, so everybody will know who's been here, if
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that's helpful to you.
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Had enough?
Okay.
Thank you for coming.
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*
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11:04 a.m.
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C E R T I F I C A T E
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I, Kay Trigilio, a Shorthand Reporter and
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Notary Public in and for the State of New York, do
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hereby certify that the foregoing record taken by me
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is a true and accurate transcript of the same, to the
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best of my ability and belief.
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___________________________
Kay Trigilio, Notary Public
State of New York
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DATE:
July 19, 2010