Vermont Integrated Eligibility (IE) Procurement Announcement

The State of Vermont, Agency of Human Services has decided to cancel the RFP titled, "Integrated Eligibility Solution Design, Development, and Implementation". This RFP was issued November 16, 2012 and proposals were due January 22, 2013.  The Agency has decided to revise and reissue the Request for Proposals.  Cancellation is per section 1.10 of the RFP. 

The State is anticipating releasing the revised RFP in March.

Vermont's Pharmacy Benefit Management (PBM) RFP Update

Happy New Year everyone and greetings from the frozen tundra of the Green Mountains!

Please be advised that due to the high volume and complexity of questions received under this PBM RFP, the State will not be posting responses to questions raised until January 6, 2014.  We apologize for any inconvenience this may cause respondents.  Please check this page for updates in relation to this RFP.  Thank you.

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The State of Vermont (State) previoiusly announced the release of its Pharmacy Benefit Management (PBM) Request for Proposal (RFP) on 12/13/2013.    The State on behalf of the Agency of Human Services (AHS), is soliciting competitive sealed bids from qualified vendors for fixed price proposals (Proposals) for a Pharmacy Benefits Management (PBM) Solution that includes PBM Operational Services and the Software Design, Development, and Technical Support to deliver those Services.

The RFP can be accessed at: http://www.vermontbusinessregistry.com/BidPreview.aspx?BidID=10338

 

This is the first of multiple RFPs related to the re-procurement of the State's Medicaid Management Information System (MMIS) that will meet our strategic goals associated with the Federal Affordable Care Act (ACA).
 

Find out more about Vermont's Health Services Enterprise at:  http://dvha.vermont.gov/administration/1health-services-enterprises.pdf and be sure to follow us on twitter (@DVHAVermont) and check our blog (http://vermont-ahs-dvha.blogspot.com/).

 

Sincerely,

 

DVHA - DHR Admin Services

c/o DVHA - Div of Health Reform

10 East Allen Street, Winooski, VT 05404

Vermont Health Services Enterprise (HSE) Update

Agency of Human Services (AHS)


October 3, 2013

There are multiple activities underway as part of our Health Services Enterprise (HSE) and we have put together this update to keep you informed. The HSE Program is an integrated system of policies, business processes and information systems that together form Vermont’s strategic Health Care vision. Further information on HSE can be found at: http://dvha.vermont.gov/administration.

Be sure to follow on twitter and check our blog: AHS-DVHA blog (http://vermont-ahs-dvha.blogspot.com/) and twitter (@DVHAVermont).

The HSE consists of:
o Vermont Health Connect (VHC)
o Integrated Eligibility (IE) system
o Medicaid Management Information System (MMIS) update project
o Health Information Exchange (HIE) and Health Information Technology (HIT)
(Clinical Public Health Information and Surveillance technologies)

The HSE Program will:
o Implement State and Federal Health Care legislation creating a 21st Century Health Care transformation
o Introduce advanced Information Technology that will ultimately extend across the State
o Enable a similar transformation for State Human Services programs while maximizing available
Federal funding
o Integrate to a single platform, the HSE projects are being deployed in an ‘Enterprise’ manner, grouping the necessary elements for each release, and maximizing reuse


Vermont continues to work closely with Centers for Medicare and Medicaid Services (CMS) and other States on a variety of issues and levels. As identified in CMS’ Seven Standards and Conditions, we need services and processes that are flexible, scalable and can be leveraged/shared across boundaries. These services and processes can be integrated in a variety of ways to address the needs of the systems we currently refer to as “VHC, IE, MMIS and HIE/HIT” but are all part of our Learning Health Network.

The following work-streams are underway within the Agency of Human Services (AHS) and Department of Information and Innovation (DII) with significant management by the Department of Vermont Health Access (DVHA):


● Vermont Health Connect (VHC):
o Congratulations to VHC team on Go-Live day!
o Launching an insurance marketplace to bring better health coverage to more Vermonters
o Ensuring Vermonters have a seamless experience finding a health plan
o Vermonters with questions should contact VHC customer support at (855) 899-9600


● Vermont’s Integrated Eligibility (IE):
○ IE team is in negotiations with a vendor for project with target date for contract in place 11/2013
○ Important dates for IE
• 12/31/14 – Requested Go-live for priority Healthcare
• 1/1/2015 – Duals (Medicaid/Medicare) Effective date
• 12/31/15 – Requested Go-live for non-Healthcare
○ IE will build off of the HSE platform in use by VHC, leveraging connections and maximizing reuse

● Vermont’s Medicaid Management Information System (MMIS):
○ Gartner has been working with Vermont to support efforts to procure a new set of vendor deployed systems capable of delivering a Medicaid Management Information System (MMIS) compliant with the Affordable Care Act, CMS architecture standards (MITA), and Vermont’s Act 48 vision. The following are RFP Release Schedule and Contract Award Targets:
• Pharmacy: November 2013 / May 2014 (DUALS)
• Care Management: November 2013 / April 2014
• Core Operations: April 2014 / October 2014
○ Link to MMIS webpage: http://dvha.vermont.gov/administration/mmis-procurement

● Vermont’s Health Information Exchange (HIE) and Health Information Technology (HIT)
o The VITL Grant has been approved for FY14
o Requirements discovery have been started with stakeholders for the development of the Statewide Clinical Registry RFP
o VITL continues to work on development of VITLAccess
o Blueprint Data Integrity Maintenance Plan Dashboard Reports are targeting Oct 31, 2013 for release
o The Vermont Strategic HIT Plan is in development for submittal to CMS

● State of Vermont RFPs can be viewed at:
○ http://www.vermontbidsystem.com/; and
○ http://www.bgs.state.vt.us/pca/bids/bids.php; and
○ http://bgs.vermont.gov/purchasing/bids


Any questions or comments can be addressed to: dvha.dhr@state.vt.us


Thank you.

VERMONT HEALTH CONNECT (VHC) is LIVE!!!

Statement from Mark Larson, Commissioner of the Department of Vermont Health Access

“I am pleased to report that Vermont Health Connect officially went live at 9 a.m. today, launching an insurance marketplace to bring better health coverage to more Vermonters. We have known all along that there will be bumps along the way, but we are working to identify any issues and resolve them quickly. As with many of the states that are launching marketplaces, we are experiencing high traffic and some access issues, but we are continuously improving our system to ensure Vermonters have a seamless experience finding a health plan. We are committed to providing Vermont’s small businesses and families with the information they need to make their health coverage decisions.

Vermonters can use the Vermont Health Connect system to compare their health plan options side-by-side by viewing the monthly health insurance premiums, co-pays, co-insurance and subsidies. Currently, information about deductibles and out-of-pocket limits is not included on the plan comparison webpage, but is available in the full plan descriptions on the website, in a separate comparison chart and can be accessed through the call center. This issue will be resolved shortly and the information will be added to the comparison page on the website soon. I am proud of our staff for their hard work to date, and I am confident that commitment will continue as Vermonters access the marketplace to make smart health coverage decisions over the course of the six month open-enrollment period.

Today marks a crucial first step in Vermont’s move to provide quality coverage, help small businesses and Vermonters afford insurance, and control the staggering increases in health care costs. Under the new program, Vermonters who do not have insurance through a job and Vermont’s small businesses and their employees, will use Vermont Health Connect to learn more about health plan options, find out if they are eligible for free or reduced-cost health coverage, and pick the best plan for themselves and their families. Today kicks-off the six month open enrollment period when Vermonters will be enrolling in new health plans. Many Vermonters will use the next couple of months to learn about and compare the new benefits available through the insurance marketplace. For Vermonters who want their plan to begin on January 1, they will have until December to pick the plan that best meets their 2014 needs.”

Update on Vermont's MMIS

Good afternoon.

With the MES Conference fast approaching, here’s a quick update regarding Vermont’s Medicaid Management Information Systems (MMIS) procurement efforts.  Vermont is working with Gartner to integrate MMIS program requirements that will inform more than one Request for Proposals (RFP) in support of the State’s vision for its next MMIS.  The number of RFPs and contracts are still being finalized but at a high level, the work-streams identified include:

·       Core MMIS operations

·       Pharmacy Benefit Management (PBM)

·       Care Management

·       Program Integrity

Vermont is projecting to release the PBM RFP by late October/November 2013, the Care Management RFP by November/December 2013, and the Core MMIS Operations RFP by May 2014.

All RFPs will require vendors to comply with Centers for Medicare and Medicaid Services’ (CMS) Seven Standards and Conditions and CMS’ Medicaid Information Technology Architecture (MITA) 3.0.   Vermont’s MMIS is an integral part of Vermont’s Health Services Enterprise (HSE) which leverages  the Oracle stack as its platform and the MMIS will need to be tightly integrated with this.  

Update on Vermont Health Services Enterprise (HSE) Activities

June, 2013

Thank you for your interest in Vermont and as you’re aware, there are a lot of activities underway as part of our Health Services Enterprise.  Due to the volume of work and the procurement activities underway, we are unable to meet all requests for meetings and/or information but we have put together this update to keep you informed of some of what’s been happening. 

Be sure to follow us on twitter and/or be sure to check our blog for information: AHS-DVHA blog (http://vermont-ahs-dvha.blogspot.com/) and twitter (@DVHAVermont).  You may share this information and links with any business partners that you wish. 

The following efforts are underway within the Agency of Human Services (AHS) with significant management by the Department of Vermont Health Access (DVHA):

●      Vermont’s Health Benefit Marketplace (Vermont Health Connect) (VHC):

○    Vermont contracted with CGI to implement Vermont Health Connect and meet Affordable Care Act requirements

●      Vermont’s Integrated Eligibility:

○    An RFP was released and the State is currently in review and final selection for the modernization of our eligibility and enrollment system

●      Vermont’s Medicaid Management Information System (MMIS):

○    Gartner has been working with Vermont to support our efforts to procure a new set of vendor deployed systems capable of delivering a Medicaid Management Information System (MMIS) compliant with the Affordable Care Act, CMS architecture standards (MITA), and Vermont’s Act 48 vision.  The following are potential Requests for Proposals (RFPs) with anticipated release dates:

                                ■    3^rd calendar quarter:  RFP for MMIS support  systems (Chronic Care, Program Integrity)

                                ■    3^rd/4^th calendar quarter:  RFP for Core MMIS system to be in place and operational prior to Jan., 2017

●      Vermont continues to work closely with CMS and other States on a variety of issues and levels.  As identified in CMS’ Seven Standards and Conditions, we need services and processes that are flexible, scalable and can be leveraged/shared across boundaries.  These services and processes can be integrated in a variety of ways to address the needs of the systems we currently refer to as “HIX, IE and MMIS” but are all part of our Learning Health Network. 

●      State of Vermont RFPs can be viewed at:

○    http://www.vermontbidsystem.com/; and

○    http://www.bgs.state.vt.us/pca/bids/bids.php; and

○    http://bgs.vermont.gov/purchasing/bids

Should Vendors have information (such as a ‘white paper’, product information, etc.) showing highly efficient and effective solutions, you can submit to Joe Liscinsky at joseph.liscinsky@state.vt.us.

Thank you.

Vermont posts RFP for NAVIGATOR ORGANIZATION GRANTS

The mission of Vermont Health Connect is to provide all Vermonters with the knowledge and tools needed to compare and choose a quality, affordable and comprehensive health plan. Although many Vermonters will use the Vermont Health Connect website to independently find, compare, and self-enroll in Qualified Health Plans (QHPs) or public health programs, individuals will also have the option to access support on the phone through the call center, either facilitating their ability to self-enroll on the website or allowing them to complete the entire application process on the phone. Still, a large number of individuals will require in-person assistance to learn about Vermont Health Connect and apply for health coverage. Vermont Health Connect will provide this in-person assistance through its Navigator Program. “Navigators” are Vermonters who will be trained and certified to provide free in-person health coverage enrollment assistance. They will also play a key role in Vermont Health Connect’s outreach and education in communities across the state, working to make sure that both individuals and small businesses know what changes are coming and can access the tools and resources they need. In order to maximize Navigators’ impact and ensure accountability, Navigators will be managed by entities selected by Vermont Health Connect to be “Navigator Organizations.”
For more information please see:  http://www.vermontbusinessregistry.com/BidPreview.aspx?BidID=9802