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Source Justification Data
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General Information
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Requesting Agency:
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Human Services
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Commodity Specialist Reviewer:
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Nicole Moyer
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Material or Service:
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Services: • Development of actuarially sound rates for the capitated Physical Health and Behavioral Health Medicaid managed care programs
• Development of actuarially sound rates for the Long-Term Living Program
• Development of actuarially sound rates for Developmental Programs
• Provide critical support for policy initiatives as directed by the Secretary’s Office including financial analysis, rate development, advice on program structure and cost control, Federal regulations, and best practices
• Development of risk-adjusted rates
• Development and review of rate-setting agreements for Commonwealth managed care programs
• Financial monitoring
• Develop fiscal and financial portions of Medicaid waivers
• Maintain encounter, diagnosis, and financial data pools to support the Commonwealth, and
• Provide program impact and financial analysis.
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E-mail:
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nicomoyer@pa.gov
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Proposed Supplier:
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Mercer Health & Benefits
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Request Type(s):
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Sole Source; Feasibility
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Description:
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This sole source arrangement will extend our current agreement with our vendor for Rate Setting, Financial Management, and Consulting Services for Medical Assistance through September of 2015. Within DPW, these services will be provided to the Office of Medical Assistance Programs, the Office of Mental Health & Substance Abuse Services, the Office of Developmental Programs, and the Office of Long-Term Living. This sole source agreement will allow more time to assure a competitive procurement process leading to a new vendor who will begin July 1, 2015, allowing for a 3-month transition period. The Department has utilized actuarial services in support of Medicaid Managed Care operations since 1995.
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Date Submitted:
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8/29/2014
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Review Information
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ID:
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23451
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Review End Date:
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Approval Status:
CS Approved:09/08/14
Submitted: 8/29/2014
Accepted: 08/29/2014
Approved by Sole Source Coordinator 09/17/2014
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Approval/Disapproval Date:
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Execution Date:
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