SSN-RC-2023-031 - SS to James McGuiness for Medicaid Reimbursement software & eStacs

PROPOSED SOLE SOURCE AWARD TO JAMES MCGUINNESS CONSULTANTS FOR A THREE (3) YEAR CONTRACT TO PROVIDE SOFTWARE UPDATES FOR MEDICAID REIMBURSEMENT AND ESTACS- TOTAL ESTIMATED AMOUNT $385,000
The County of Rockland Department of Health (RCDOH) is considering the issuance of a Sole Source award to James McGuinness Consultants for the provision of Software for Medicaid Reimbursement and eSTACs.   
This award may be made on a sole source basis in accordance with the Rockland County Procurement Policy.
TERM: January 1, 2022- December 31, 2025
SCOPE
The County of Rockland Health Department is currently using the software Preschool Launch and Committee for Preschool Education Portal to track Medicaid reimbursement. A fixed fee of 5% of the Medicaid reimbursement will be paid to the consultant.   
The Rockland County Department of Health is looking to expand the services and add Full-Service Medicaid reimbursement, unlimited support, the use of Medicaid service bureau through the CPSE Portal, as well eSTACs program software. STACs are hard copies which are mailed to the Finance Department.  This update of the eSTAC program software will allow all STAC’s to be completed electronically through this module. 

PROGRAM SERVICES FOR MEDICAID REIMBURSEMENT

• Bimonthly Meetings with written agendas until the RCDOH determine they are no longer required   
• Scheduled weekly meetings with Preschool Coordinators to address questions and concerns as well as correct any Medicaid denials
• Ensure all claims meet Medicaid compliance and are eligible for reimbursement. Which will include all documents are uploaded and maintained. 
• Training webinars for Providers. All trainings are to be recorded and available to all registrants.  Training is to include:
  • IEP Discrepancies
  • Prescription Issues both hard copy and digital
  • Unmatched Children and enrollments
  • Document verification
  • OPRA
• Prescription verification which will include verifying forms and returning for correction to meet Medicaid compliance.
• Credential verification including Ordering/Prescribing/Referring/Attending (OPRA) numbers required for Speech and Language Pathologist (SLP)
• Digital Speech Recommendations upon implementation and annually
• Medicaid -Compliant Written orders upon implementation and annually
• 2023 Annual Review process and subsequent years

• Verification of all Physicians prescriptions
• Obtain corrected prescriptions from the providers
• Verification of all Digital Orders
• Obtain corrected digital orders from the SLP
• Verification of Medicaid Consent forms for all children evaluated by School Districts regardless of their Medicaid status or parent refusal
• Obtain corrected consents from parent with the assistance of the Preschool    Coordinator
• Medicaid reimbursement for transportation for 2023
• Meetings with the RCDOH Finance Team upon request

• Bimonthly meetings with written agendas upon implementation until the RCDOH determine they are no longer required
• Scheduled Weekly meetings with Preschool Coordinators to address questions and concerns
• 24 hours response to questions from providers and chairpersons
• Training for entering STAC-1’s for Center based Programs and Related Services and SEIT
• Training for entering STAC-5’s for evaluations
• Meetings with the RCDOH Finance Team as needed