Task 1: Develop State-Specific Project Work Plan At the onset of the contract, the Vendor shall attend and participate in an initial project kick-off and planning meeting. This will entail a face‐to‐face meeting in New Castle, Delaware lasting approximately three (3) hours. During this meeting, DHSS and the selected Vendor, will collaborate and discuss the overall Project Work Plan, including (1) clarifying project expectations; (2) discussing data requirements, (3) reviewing key tasks, (4) reviewing required deliverables and the submittal schedule, as well as (4) discussing an overall project timeline. Within twenty (20) business days following this meeting, the Vendor shall submit a detailed project work plan for the three (3) contract years and containing all known tasks, deliverables, and milestones; inclusive of the beginning and ending dates for all defined tasks, deliverables, and milestones. The Vendor will update this work plan before the start of each state fiscal year (July 1st through June 30th). This plan will be used to verify and confirm services and tasks that both the State and the Vendor expect to complete each state fiscal year. It is the State’s expectation that the Vendor provide a draft of the yearly project work plan update for state approval by May 1st of each year. Deliverable 1a: Initial Detailed Project Work Plan The Vendor shall submit an initial detailed project work plan for the State to review after meeting with DHSS and within twenty (20) business days following the project kick-off and planning meeting. This work plan will cover the initial three (3) years of the contract. As part of the initial Project Work Plan, the selected Vendor must provide a technical and project transition plan to DHSS for approval that demonstrates readiness to begin providing services. Prior to the selected Vendor providing any services, DHSS will review the initial work plan to determine whether the selected vendor is carrying out its implementation as submitted in response to the RFP and agreed upon by DHSS. The selected Vendor is solely responsible for the cost of all work during the review for readiness and undertakes the work at its sole risk. The selected Vendor must coordinate data exchange with the current Contractor. If DHSS determines that the selected Vendor is not ready to begin providing services on the program start date, it may, at its sole discretion, delay the start of the contract and require corrective action, or terminate the contract. Deliverable 1b: Annually Revised (Updated) Work Plan The Vendor will update and submit the revised work plan that identifies all tasks and deliverables to be completed and produced during the upcoming state fiscal year by May 1st of every year. This plan should consider all known Federal and State program and policy changes that will affect the Delaware Medicaid program. Task 2: Managed Care Organization Capitation Rate Setting The Vendor will develop actuarially sound capitation rates for DHSS contracted managed care organizations (MCOs) on an annual basis, and more frequently, as needed due to program changes, in accordance with 42 CFR 438.6(c) CMS Medicaid Managed Care Rate Development Guidelines. DHSS MCO contracts are full risk contracts that are based on a calendar year, rather than on the state/federal fiscal year. DHSS requires rates to be changed annually, each calendar year (January through December). However, Vendors should assume and plan for an additional/interim rate change, in addition to the annual MCO rate change, each year due to changes in policy, benefits, and coverage.
