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					        Acquisition RFP No.0456-153 Amendment #2                                                                    July 9, 2004
                                                                                                                    Page 1 of 28

        Note: These DSHS Answers to Bidders’ Questions may only explain or clarify some aspect that is already addressed in
        the RFP. But some of the answers may also supplement or change what was previously stated in the RFP, or in an
        exhibit.

        Therefore it is important that bidders review all questions and answers, and not just those that they may have submitted.


   RFP
                  Question                                                DSHS Answer
 Reference


1.8.2             Dates for start and end on tasks 1.9.1 & 1.9.2 &        Tasks 1.91, 1.92 and 1.93 represent project milestones in the
                  1.9.3 show identical Planned start and planned end      project schedule presented in section 1.8.2. See section
                  dates. These are inconsistent with verbal in 1.8.3      1.8.3 and 2.10.10 for descriptions and timelines of each
                                                                          implementation phase.

2.6.4.11          Is DSHS requiring vendors to employ CMM                 CMM processes and practices are not required. Bidders can
                  processes and practices in this project? Can we         propose their own industry accepted methodologies.
                  propose our own/industry accepted methodologies?        However, favorable scores will be given to requirements
                                                                          2.6.4.11 and 2.6.4.12 for Bidder’s who demonstrate
                                                                          knowledge and competence in CMM processes and
                                                                          practices and who propose to employ those processes and
                                                                          practices on this project.
2.7.1.3 (a-l)     There are 12 functions listed – some indicating         Yes, the same person could fill more than one role identified
                  multiple staff. Can one person perform more than        in 2.7.1.3.
                  one of these roles?
2.7.5.6           We believe it is too onerous for DSHS to have           As stated in requirement 2.7.5.6, DSHS requires that the
                  unilateral ability to change and interview all staff.   vendor provide prior written consent for a change in “Key
                  We would agree to a provision that would allow this     Staff” only, not all staff. DSHS will only participate in
                  for key staff, but not “all staff”.                     interviews for Key Staff replacements.
     Acquisition RFP No.0456-153 Amendment #2                                                                     July 9, 2004
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   RFP
             Question                                                   DSHS Answer
 Reference
2.7.5.7      We believe it is too onerous for DSHS to have this         DSHS does not intend to have the right to require a change
             capability over our subcontractors. We would agree         in vendor’s subcontractor’s unless, a “Key Staff” position is
             to it for staff (our own or subs) if they are designated   filled by a sub-contractor.
             as “key” staff only.
2.10.7       For Item #3 there is approx. 15 years of data that will    A typical year of MMIS claims data is as follows:
             need to be converted. Can you provide us with a
             sizing estimate of the data involved for storage,          Claims-22 million records, 5500 mg of raw data
             conversion, and retrieval rates to be able to perform
             at required SLA levels.                                    Line items-30 million records, 5010 mg of raw data

                                                                        Hosp Procedures-1.5 million records, 37.5 mg of raw data

                                                                        Diagnosis-22 million records, 572 mg of raw data

                                                                        Pharmacy/POS-9 million records, 549 mg of raw data
     Acquisition RFP No.0456-153 Amendment #2                                                                 July 9, 2004
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   RFP
             Question                                                DSHS Answer
 Reference
2.10.8       Does the UAT (User acceptance test) partition need      The UAT is one partition within the Integrated Test Facility.
             to be a separate system from the ITF (Integrated test   The UAT environment is intended to be used to test any
             facility) and if so what is the requirements for        required system functionality but will not be required to be
             performance? Simple functionality or load testing?      used for load testing as long as the vendor performs load
                                                                     testing and provides results to DSHS for approval prior to
                                                                     migration to production. Performance requirements for the
                                                                     UAT environment are:
                                                                      Available 99.9 % of the time during normal business
                                                                         hours of 6:00AM – 7:00PM, M-F. Available 97% of the
                                                                         time during off-business hours.
                                                                      Ability to satisfy response time requirements for 100
                                                                         concurrent internal state users during normal business
                                                                         hours.
                                                                      Record Search and/or Retrieval Time must not exceed 5
                                                                         seconds for 95% of all record searches/retrievals.
                                                                      Screen Edit Time must not exceed 3 seconds for 95% of
                                                                         the time.
                                                                      Next Page Edit Time must not exceed 3 seconds for 95%
                                                                         of the time.
2.10.20.7    How many staff are to be trained for each of the 12     The number of potential MMIS users that require training is
2.10.10.7    areas? Are there any limitations on out of state        600. In addition, 425 data warehouse users require training
             travel – can some of these roles be trained at a        per RFP Section 4.16. Training must be provided on site.
             vendor’s off site training center? Can you provide      DSHS recognizes the potential benefits of, and is open to the
             some indication if Placeware or videoconferencing is    use of, Placeware or videoconferencing as training tools.
             available in any of the sites?                          However, these tools are not widely available within DSHS.
       Acquisition RFP No.0456-153 Amendment #2                                                                      July 9, 2004
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   RFP
               Question                                                 DSHS Answer
 Reference
3.12           Please explain the “shared interface component”          The shared interface component refers to middleware
               and provide a description of a problem situation that    technology. DSHS would like the vendor to provide a solution
               the agency is trying to resolve.                         that would reduce the number of point to point interfaces. For
                                                                        example, eligibility data comes from multiple systems today,
                                                                        all of which have their own interface directly to the MMIS. It
                                                                        is desirable to have all source systems feed a common
                                                                        middleware component that would subsequently send a
                                                                        single file to the MMIS.
4.1.1.2        Does the agency have documentation available (to         The current Health Insurance Premium payment process will
               be added to procurement library) on the current          be added to the procurement library under the heading
               process, including inputs and outputs, for making        “Business Process Documentation”.
               paying Health Insurance Premium payments?
4.1.2.3        Other than the ability to maintain (edit/update) a       It is the intent of DSHS in the future to capture a client’s
               client’s individual and household income and the         income in order to calculate premiums and participation
               source of the income, how is this information used in    amounts.
               the MMIS?
4.1.2.14       This requirement indicates the system                    The user needs to be able to use standard sets of data
               functionality must include "Ability to assign standard   elements associated with a client, such as county, zip code,
               attribute sets to each client (e.g. classification       etc and consider these data elements as part of a standard
               system to identify demographic and other                 reporting structure.
               parameters".

               Please clarify what is meant by “attribute sets and
               other parameters” to ensure correct interpretation of
               this requirement.
4.1.2.22       Please provide an example of how claims history          An example would be obtaining claims history data for a
               information is used to support eligibility.              client with a diagnosis of kidney disease or diabetes. These
                                                                        clients could then be targeted for eligibility into the disease
                                                                        management program.
     Acquisition RFP No.0456-153 Amendment #2                                                                            July 9, 2004
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   RFP
                Question                                                     DSHS Answer
 Reference
4.1.2.25 & 26   The “inquiry system” must support the following two          The user needs to be able to search for a client or a group of
                items:                                                       clients by specifying attributes of the client(s) and having the
                     Ability for eligibility inquiry response to            system return a list of clients matching those attributes.
                       provide eligible services and limitations
                     Ability to query on recipient attributes, as
                       defined by the user.

                Can you define more clearly what is meant by
                "ability to query on recipient attributes”? Do you
                mean to inquire to identify a recipient based on
                attributes like the "Eligibility category, geographic zip
                code, Name, address, SSN, DOB, etc." or a
                combination of these, in order to identify a recipient
                record to view?

                Or, do you mean the ability to query and select and
                retrieve a specific attribute or set of attributes after
                the recipient has been identified? For example, are
                you asking to retrieve and view the recipient’s record
                with all its attendant attributes like the recipients age,
                DOB, address, sex, family ID number, PCP, TPL
                information?
     Acquisition RFP No.0456-153 Amendment #2                                                                       July 9, 2004
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   RFP
             Question                                                 DSHS Answer
 Reference
4.1.2.28     Each state tends to process spend down a little          A general description of our intended approach would include
             differently, please provide a description on how         the following items-
             spend down is updated within the MMIS. Are claims         The spend-down requirement is determined in the client
             the only transactions that update spend down?               eligibility system and passed to the MMIS through an
                                                                         interface.
                                                                       The eligibility system also records contributions towards
                                                                         the spend-down requirement and passes this data to the
                                                                         MMIS.
                                                                       Spend-down contributions are also recorded from the
                                                                         “patient pay” amount on Medicaid claims received from
                                                                         providers.
                                                                       The spend-down contributions and balance is maintained
                                                                         in the MMIS system.
                                                                       The spend-down contributions and balance is also
                                                                         interfaced back to the eligibility system.
4.2.2.9      How is this information used in the MMIS? Is it          This information is captured during the provider enrollment
             limited to provider enrollment?                          process, but used in claims editing. For example in the
                                                                      Prosthetic & Orthotic program, there are certain services
                                                                      allowed only if the provider has licensure.
4.2.2.29     How is this information used in the MMIS?                This information is used in claims editing.
4.4.2.13     What data repositories need to be converted at time      There is one database that contains prior Authorization data
             of implementation? Please identify the number of         for medical services. It is a SQL Server database that is 268
             repositories, the size of each, and the format/type of   mb of data.
             database of each.
                                                                      The SSPS contains a file with authorization data. The file is a
                                                                      sequential file consisting of approximately 840,000 records at
                                                                      444 bytes per record.
4.4.2.14     How does the state identify whether a service is         We currently are not able to identify if a service is available
             available through an in-state provider?                  through an in-state provider.
     Acquisition RFP No.0456-153 Amendment #2                                                                 July 9, 2004
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   RFP
             Question                                             DSHS Answer
 Reference
4.4.2.29     Please describe the method and hierarchy used in     Currently we receive additional required information from
             PA processing, or examples of how the agency         providers in determining approval to receive a requested
             might want to prioritize PAs.                        service. This information is currently loaded into a local
                                                                  database in a pended status until a clinical review team can
                                                                  make a determination. It is the desire of DSHS to use MMIS
                                                                  to track these pended auth records by date of receipt and
                                                                  status and retrieve the oldest dates first when queuing a
                                                                  desired auth location.
4.6.3.18     What types of claims and situations would apply to   This could apply to institutional, professional or dental claims.
             this type of pricing override?                       An example of a professional claim would be a secondary
                                                                  bilateral trauma surgery procedure. The user currently has to
                                                                  reduce the allowed amount on a secondary procedure by
                                                                  half, and then calculate the additional trauma reimbursement.
                                                                  DSHS would like the ability to have the system review all
                                                                  modifiers, select the appropriate hierarchy of pricing
                                                                  methodology and pay the service accordingly.
4.17.1.2     Please provide documentation on the existing phone   The current PBX service is provided by two Avaya survivable
             system.                                              remotes that are fiber connected to an Avaya G3R running
                                                                  Version 11 software. The G3R has 20 other EPNs
                                                                  (Remotes) connected to it and is used to provide service to
                                                                  over 5000 other subscribers on that same G3R. The system
                                                                  is networked in a common 5 digit dial plan to two other G3Rs
                                                                  that serve the Capitol Campus area using Avaya ISDN DCS.
                                                                  In total this PBX network serves over 15,000 subscribers.

                                                                  The system currently uses Avaya Call Center Deluxe ACD
                                                                  software. Prior to the scheduled implementation of the new
                                                                  MMIS it is expected that the G3R will have been upgraded to
                                                                  the Avaya S8700 architecture and will be using Call Center
                                                                  Elite software.
       Acquisition RFP No.0456-153 Amendment #2                                                                       July 9, 2004
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   RFP
               Question                                                  DSHS Answer
 Reference
4.19           (a) Is it the state’s intent to pay for the cost of the   (a) The following amendments to the RFP are intended to
               POS or other equipment that will be used for reading      clarify the electronic swipe card questions.
               the new plastic ID card? Or, will the cost be the
               responsibility of the provider? Other than to verify      RFP Section 4.19, Page 207, paragraph 2. Change first
               Medicaid eligibility, can the swipe machines be used      sentence from “The successful Vendor must provide and
               to check claim status and check (warrant) amounts         implement card readers for approximately 15,000 providers
               as well as commercial payers and Medicare?                across the state.” To “The successful Vendor must provide,
                                                                         implement and maintain card readers to providers across the
               (b) By utilizing a unique card identifier for             state who request the devices. Bidder will include the cost of
               replacement cards, are you requiring the use of a         the devices, installation and maintenance as part of their bid
               number other than the Medicaid identification             (See Requirement 4.19.12)”.
               number on the card such as a card control number?
               Please explain.                                           Add the following requirement (4.19.12)
                                                                         Ability to provide, install and maintain, in provider offices,
               (c) If a vendor could demonstrate that a required         card reader devices to verify Medicaid eligibility.
               function could be implemented earlier than its
               assigned phase and provide the state with benefits        Note: Price this requirement separately per instructions
               in so doing, could a system requirement be                in Section 5, Financial/Contractual Requirements and
               implemented earlier?                                      Appendix AC – Cost Proposal. Price card reader
                                                                         equipment, installation and maintenance per unit.

                                                                         Appendix AC – Cost Proposal Form, Section 2. Add the
                                                                         following Requirement (Requirement f) to the list of
                                                                         Separately Priced Requirements.
                                                                         “Magnetically Encoded Client ID Card Reader Devices. Price
                                                                         per unit”.
                                                                         (Requirement #4.19.12)

                                                                         (b) In addition to the client identification data, the card must
                                                                         contain a unique card identifier or card control number. This
       Acquisition RFP No.0456-153 Amendment #2                                                                 July 9, 2004
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   RFP
               Question                                              DSHS Answer
 Reference
                                                                     number must uniquely identify the physical card. This
                                                                     number will be used to activate, disable and manage the use
                                                                     of cards so that only one card per client is active at any given
                                                                     time, allow for replacement of lost or damaged cards, etc.

                                                                     (c) The state will be open to the discussion of early
                                                                     implementation dates during the development of the project
                                                                     work plan.
4.21           How does this requirement relate to providing a       This requirement relates to all software over which the
               common user interface between third party/COTS        vendor has control or influence over the user interface. The
               products in which the selected vendor would not       project recognizes that some third party/COTS application
               have the ability to modify?                           will not be modified to conform to the user interface style of
                                                                     the proposed MMIS.
4.21.25        Since the federal government does not provide “508”   Many organizations, such as World Wide Web Consortium
               certification; compliance can be subjective to        (W3C) http://www.w3.org/WAI/eval/
               interpretation. What mechanism/process will the       provide resources for evaluation, repair and transformation
               agency use to determine “508” acceptance?             tools for web content accessibility, including 508.

                                                                     We expect the successful vendor to use compliance
                                                                     checking software and assure DSHS of its compliance.
                                                                     DSHS retains the option to perform compliance checking.
        Acquisition RFP No.0456-153 Amendment #2                                                                     July 9, 2004
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   RFP
                Question                                                 DSHS Answer
 Reference
7.1.2           “Qualified Bidders will be asked to present an in-       The technical architecture presentation is part of the
                depth explanation of its proposed technical              Technical Evaluation. It is a presentation to the Technical
                architecture to the team prior to final technical        Evaluation Team only and is separate from the Oral
                proposal scoring.” Oral presentations appear to be       Presentation.
                scheduled for after the final scoring of the Technical
                Proposal and opening of the Cost Proposal.               This presentations will be held after written proposal
                                                                         evaluations during the week of August 30th-September 3rd.
                Will this technical architecture presentation be
                conducted as part of the Oral Presentations? How
                will this be factored into the final scoring of the
                Technical Proposal?

                If not during the Oral Presentation, when during the
                evaluation process will the technical architecture
                presentation take place?
Appendix AA     Is State requesting Title, ownership rights to Vendor    The State is requesting ownership rights to products which
– Sample        owned intellectual property and any of its vendors       result from the Services performed by the Contractor under
Agreement –     intellectual property?                                   the Agreement, including Deliverables such as the Detailed
1.24; 1.26                                                               System Design Deliverable, and other intellectual property
                                                                         developed in the course of rendering the Services and
                                                                         incorporated into such products. The Vendor is not required
                                                                         to transfer ownership to its preexisting intellectual property or
                                                                         that of its vendors which will be licensed under Section 8.1.3.
Appendix AA     Does Design/Development begin on the Effective           Design/Development shall begin on the Effective Date as
- 5.1           Date as under the Agreement, or as under the RFP         defined in Section 1.33 in Appendix AA – Sample Contract
                Section 1.8 on 12/31/04 or 1/05?                         (Agreement). The schedule provided in RFP Section 1.8
                                                                         assumes DSHS executes the Agreement no later than
                                                                         1/18/05, following CMS approval of the Agreement.
    Acquisition RFP No.0456-153 Amendment #2                                                                    July 9, 2004
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   RFP
              Question                                               DSHS Answer
 Reference
Appendix AA   Does the title to Property which Contractor            This section requires transfer of title to all Property which is
- 5.3         purchases and must pass to DSHS include licenses       purchased by Contractor and for which Contractor has been
              for software that Contractor acquires for              reimbursed by DSHS, such as licenses for Software included
              performance?                                           as part of the System. Such licenses will be transferred on
                                                                     the earlier of Acceptance of the Deliverable in which the
                                                                     software is included or Acceptance of the System. However,
                                                                     there may be situations where such licenses cannot be
                                                                     transferred because of restrictions imposed by the third party
                                                                     licensor. In such situations, the Contractor must apprise the
                                                                     State in advance of such limitations and obtain the State’s
                                                                     advance permission to use such software in the system. See
                                                                     Section 8.1.8.
Appendix AA   Does Property under this Section refer to Contractor   DSHS Property. Property is defined as “All DSHS Equipment
- 5.7         Property as referenced under Section 5.3, or DSHS      and other DSHS real and personal property.” Such Property
              Property?                                              might include DSHS workstations, for example, being used
                                                                     on the Project. Property referenced in this section does not
                                                                     include Contractor Technology. See the discussion above
                                                                     regarding Property addressed in Section 5.3.
    Acquisition RFP No.0456-153 Amendment #2                                                                      July 9, 2004
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   RFP
              Question                                                DSHS Answer
 Reference
Appendix AA   Could State clarify the difference between the          As described in the Agreement, Section 7.4.1 requires the
- 7.4.1       request for a copy of the Source Code under 7.4.1       Contractor to provide DSHS with a copy of the Source Code
              and that under 7.4.2?                                   for the Custom Software and for the Application Software
                                                                      which is licensed by Contractor to DSHS in Source Code
              If third parties who own the Third Party Software,      form. Such Application Software might include Third Party
              Subcontractors who own the Proprietary Software,        Software which its licensor, such as PeopleSoft, provides in
              or parties who own the Transfer Software will not       Source Code form. However, as described in Section 7.4.2,
              provide copies of Source Code of their intellectual     for Application Software which is only licensed to the
              property (software), except under a Source Code         Contractor by its licensor in Object Code form, the Contractor
              Escrow Agreement as in 7.4.2, what is the State’s       should make the Source Code for such Software available
              alternative to its request under 7.4.1?                 through an escrow arrangement, as described in Exhibit D. If
                                                                      the Source Code for such Application Software is not even
                                                                      available through an escrow, the Contractor has to apprise
                                                                      DSHS in advance and obtain prior consent to use of such
                                                                      Software in the System as described in Section 8.1.8.
Appendix AA   Is the correction of the Application Software Source    Correction is required at no cost to DSHS because the
- 7.4.2       Code and/or associated technical Documentation          Contractor cannot charge additional amounts to perform what
              considered part of verification and therefore, at the   it should have done initially to meet its obligations under the
              additional cost to DSHS? If not, is a distinction       Agreement by providing the Source Code and
              made between whether or not such correction is          Documentation required by the Agreement.
              required through no fault of Contractor?

              Is the need for a correction deemed a Deficiency?       The need for a correction would be a Deficiency if the
                                                                      correction is to fix a failure of a Deliverable or an omission,
                                                                      defect or deficiency in a Deliverable which causes it not to
                                                                      conform to its Specifications.

              If Contractor cannot make the necessary corrections     The verification would be conducted by the escrow agent or,
              within the allotted 10 days, would this be a            upon at least ten business day’s prior notice to Contractor, by
              consideration for DSHS to terminate the agreement?      a DSHS representative. If DSHS found a failure by the
    Acquisition RFP No.0456-153 Amendment #2                                                                  July 9, 2004
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   RFP
              Question                                               DSHS Answer
 Reference
              If so, does DSHS take into consideration whether       Contractor to perform as required in this Agreement, the
              such correction was required through no fault of       Contractor would have to promptly correct inaccuracies or an
              Contractor?                                            incomplete escrow within ten days from notice by DSHS of
                                                                     such failure. If Contractor cannot make the necessary
                                                                     corrections within such time period, this failure would be a
                                                                     breach, entitling DSHS to pursue termination of the
                                                                     Agreement as provided in Section 22.1. However, if such
                                                                     failure was due to causes beyond the Contractor's
                                                                     reasonable control as described in Section 23.13, Contractor
                                                                     would not be liable for such failures.

              Does the verification require Contractor to submit a   Neither and neither. This verification process would be
              separate proposal and pricing information or is it     similar to an audit situation which does not allow submission
              considered a Change Request? Is it a unilateral        of a proposal by the Contractor. The Contractor can
              Change Request issued by DSHS or does                  minimize or avoid incurring any such costs associated with
              Contractor have the right to accept or reject such     this process by ensuring compliance with the requirements of
              request?                                               Section 7.4.2, such as by regularly notifying DSHS of how it
                                                                     is in compliance or by providing Source Code for all of the
                                                                     Software.
Appendix AA   Who is considered DSHS authorized representative       The DSHS Project Manager or designee.
- 7.6         under this Section?
Appendix AA   The Representation seems to imply that a specific      Acceptance will never be “deemed” to occur after the
- 7.8         time period has to pass prior to Acceptance being      passage of time. Final Acceptance of any Deliverable will
              deemed final, could State clarify or identify the      occur after DSHS has had time to review the draft
              specific time period prior to final Acceptance?        Deliverable, request updates to the Deliverable from the
                                                                     Contractor and review and approve the final Deliverable.
                                                                     Bidders should incorporate ample time in their work plans for
                                                                     this review and approval process to occur. The specific time
                                                                     period will be described and mutually agreed upon in the
                                                                     Work Plan.
    Acquisition RFP No.0456-153 Amendment #2                                                                      July 9, 2004
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   RFP
              Question                                                 DSHS Answer
 Reference
Appendix AA   Will State maintain records for copies it makes of       Where “Application Software” refers to the transfer system
- 8.1.5       Application Software?                                    and any modifications made to such system as part of the
                                                                       Agreement, the State is not bound by Agreement to
                                                                       document copies or provide such documentation to the
                                                                       Contractor. However, it is common practice to document
                                                                       copies the State makes for internal purposes.
Appendix AA   Will these restrictions apply to Application Software    These restrictions apply to any Third Party Software which is
- 8.1.6       and to Source Code software?                             provided only in Object Code form. Depending on the
                                                                       solution that is bid by the Contractor, the State would be
                                                                       willing to discuss whether it should apply to other parts of the
                                                                       Application Software.
Appendix AA   Will State require this same process for                 Yes, if the Subcontractor software is in anyway integrated
- 8.1.8       Subcontractor software?                                  into the Contractor’s MMIS solution.
Appendix AA   Does this provision also apply to Subcontractor          Yes, if the Subcontractor software is in anyway integrated
- 8.1.9       software?                                                into the Contractor’s MMIS solution.
Appendix AA   Could State clarify or identify “all appropriate State   The current appropriate agencies are DSHS and CMS, but
- 8.2         and federal agencies”?                                   those agencies could change based on regulatory and
                                                                       statutory changes or requirements of CMS and the State.

              Under this Section, does the reference to “Federal       No. 45 CFR 95.617 applies to Software and ownership rights
              Financial Participation”, due to the allocation of       and 45 CFR 92.34 applies to licenses of copyrights. These
              Federal funds for Medicaid, require that State, and      limitations are not unique to Washington because the
              all appropriate State and federal agencies be            federal regulations apply to every state’s MMIS. 45 CFR
              granted irrevocable licenses to all of the Transfer      617 states:
              Software, Proprietary Software, and Third Party
              Software?                                                       Software and ownership rights.

                                                                              (a) General. The State or local government must
                                                                              include a clause in all procurement instruments that
   Acquisition RFP No.0456-153 Amendment #2                                            July 9, 2004
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  RFP
            Question                          DSHS Answer
Reference
                                                   provides that the State or local government will have
                                                   all ownership rights in software or modifications
                                                   thereof and associated documentation designed,
                                                   developed or installed with Federal financial
                                                   participation under this subpart.
                                                   (b) Federal license. The Department reserves a
                                                   royalty-free, nonexclusive, and irrevocable license to
                                                   reproduce, publish, or otherwise use and to authorize
                                                   others to use for Federal Government purposes, such
                                                   software, modifications, and documentation.
                                                   (c) Proprietary software. Proprietary operating/vendor
                                                   software packages (e.g., ADABAS or TOTAL) which
                                                   are provided at established catalog or market prices
                                                   and sold or leased to the general public shall not be
                                                   subject to the ownership provisions in paragraphs (a)
                                                   and (b) of this section. FFP is not available for
                                                   proprietary applications software developed
                                                   specifically for the public assistance programs covered
                                                   under this subpart.
                                              45 CFR 95.617 (emphasis added). 45 CFR 92.34 states:
                                                   Copyrights.

                                                    The Federal awarding agency reserves a royalty-free,
                                                    nonexclusive, and irrevocable license to reproduce,
                                                    publish or otherwise use, and to authorize others to
                                                    use, for Federal Government purposes:
                                                    (a) The copyright in any work developed under a
                                                    grant, subgrant, or contract under a grant or subgrant;
                                                    and
                                                    (b) Any rights of copyright to which a grantee,
   Acquisition RFP No.0456-153 Amendment #2                                           July 9, 2004
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            Question                          DSHS Answer
Reference
                                                    subgrantee or a contractor purchases ownership with
                                                    grant support.

                                              45 CFR 92.34.

                                              The sample contract language and the explanation below are
                                              based on the interpretation of these regulations that only
                                              Custom Software and modifications/changes to Custom
                                              Software are covered by 45 CFR 95.617. However,
                                              Washington is asking CMS for clarification on its
                                              interpretation of these regulations. Depending on CMS’s
                                              response, the sample contract language may need to be
                                              modified. As stated above,, these regulations apply to every
                                              state’s MMIS, so these requirements are not unique to
                                              Washington.

                                              Custom Software is defined as “[t]he modifications and
                                              changes to the Application Software and other software,
                                              including without limitation Interfaces, designed, developed
                                              or produced by Contractor under the Agreement.” The text in
                                              Section 8.2 of the Agreement applies only to Custom
                                              Software and modifications of the Custom Software, and
                                              associated Documentation designed, developed, or installed
                                              with Federal Financial Participation under the Agreement.
    Acquisition RFP No.0456-153 Amendment #2                                                                         July 9, 2004
                                                                                                                    Page 17 of 28

   RFP
              Question                                                    DSHS Answer
 Reference
Appendix AA   Could State expound upon “including without                 Use of “including without limitation” in Section 9 is intended to
-9            limitation” to identify what other intellectual property    make clear that ownership rights for DSHS are expansive for
              rights it requires Contractor to assign title, right, and   the Deliverables, except as provided below in that Section.
              interest to DSHS?                                           As the contract is written, the exception is for the Application
                                                                          Software which will not be owned by DSHS for purposes of
                                                                          Section 9. However, as stated above in the Answer to the
                                                                          preceding question, Washington is seeking clarification from
                                                                          CMS that may require this contract language to be revised.
Appendix AA   Could State clarify whether it is requiring                 Washington is unsure about what performance this question
- 13.1.4      performance under RFP, for instance DD, to be 24            is asking. See RFP Section 4.26 and Appendix AA, Exhibit C
              hours a day, 7 days a week, 365 days a year?                for specific performance requirements/standards.
Appendix AA   Is this a requirement during the term or indefinitely?      During the term.
- 13.6.1
Appendix AA   What is the time period for developing the temporary        In the case of a deficiency where there is an acceptable
- 13.9        solution or emergency bypass?                               workaround or bypass identified (See Appendix AA, Exhibit
                                                                          C, Item 11 “Level 3”), the vendor will be given 8 hours from
                                                                          the time the deficiency is reported to implement the
                                                                          workaround or bypass.
Appendix AA   Will Contractor be liable for fines, penalties, or          Yes, unless the fines, penalties, or disallowances imposed
- 15.3        disallowances imposed resulting from the act or             result from acts or omissions of DSHS which are outside the
              omission of DSHS?                                           reasonable control of the Contractor and without fault or
                                                                          negligence of the Contractor.
    Acquisition RFP No.0456-153 Amendment #2                                                                  July 9, 2004
                                                                                                             Page 18 of 28

   RFP
              Question                                            DSHS Answer
 Reference
Appendix AA   Is the DSHS Project Manager’s determination of      Yes, subject to the parties having first pursued the process
- 15.8        revised price and Schedule always a unilateral      described in Section 15.8 to negotiate in good faith and then
              determination?                                      failed to reach agreement within 15 days of Contractor’s
                                                                  response to a Change Request from DSHS.

              What is Contractor’s process for not performing a   Contractor would have the right to pursue the dispute
              unilateral Change Request that would cause          resolution process if it disagreed with the price and schedule
              Contractor a financial loss and would this be       unilaterally decided upon by the DSHS Project Manager. If
              grounds for termination of Agreement?               the Contractor ignored the DSHS Project Manager’s
                                                                  decision, refused to perform in accordance with the Change
                                                                  Order, and not pursued this process, the Contractor would be
                                                                  in material breach and subject to termination under Section
                                                                  22.1.

              Would State consider making the revised price and   No, not for the unique situations described in Section 15.8 if
              Schedule determination a mutual determination?      federal or state laws, rules, regulations, policies or guidelines
                                                                  are adopted, promulgated, judicially interpreted or changed.
Appendix AA   Will Contractor have the opportunity to object to   Section 19.1.2 describes the process that applies when
- 19.1.1      DSHS disclosure of Confidential Information, for    DSHS is required to notify the Contractor if a request is made
              instance to Contractor’s competitors?               to view Contractor’s Proprietary Information or Confidential
                                                                  Information.
    Acquisition RFP No.0456-153 Amendment #2                                                                         July 9, 2004
                                                                                                                    Page 19 of 28

   RFP
              Question                                                    DSHS Answer
 Reference
Appendix AA   Would DSHS hold Contractor liable for modifications         If the Vendor is referring to changes to software, DSHS does
- 20.1.3      made by DSHS through no direction by Contractor             not anticipate making such changes (except normal table
              or for other changes made by DSHS or for any                administration/updates) without working with the cooperation
              DSHS combined or unauthorized use of the                    of the Contractor. The Contractor would be liable for
              Deliverables?                                               Deficiencies which were caused by modifications made to the
                                                                          System by DSHS if the Contractor knew or should have
                                                                          known that DSHS would or was likely to make such changes
                                                                          and the Contractor had not directed DSHS not to make such
                                                                          modifications or indicated in some other document or
                                                                          representation that DSHS could not make such changes or
                                                                          not combine the System with other products.
Appendix AA   What are the DSHS ramifications against Contractor          DSHS would be entitled to pursue its available legal
- 22.9.2.3    if it cannot settle all outstanding liabilities and all     remedies for the Contractor’s failure to meet such
              claims arising out of DSHS termination within 30            obligations, including damages caused by such failures,
              days due to confines of law or contract?                    unless Section 23.13 (Force Majeure) applies.
Appendix AA   What is the definition of “property” used under this        This “property” is broader and more general than the defined
- 22.9.2.7    Section vs. “Property” used under 22.9.2.6 where            term “Property”. To clarify this point, we will delete “such”
              the requirement to surrender Property is noted?             before “property” in that line.
Appendix AA   Could State clarify whether State’s use is at no cost       State’s use following termination will be at no additional cost
- 22.9.3.2    or whether it is at a cost and will be retroactive to the   because the cost will have been included in the original cost
              date of termination?                                        for any such technology. The sample contract will be
                                                                          modified to reflect this change.
Appendix AA   Would DSHS requirement that Contractor provide              As stated in the last sentence of the referenced section,
- 22.9.3.4    “any turnover assistance Services necessary” be at          “Contractor will ensure that all consents and approvals to
              a cost to Contractor or to DSHS?                            allow Contractor and Subcontractors to provide the
                                                                          assistance required following termination……will be provided
                                                                          by the applicable third parties at no [cost] or delay to DSHS.
    Acquisition RFP No.0456-153 Amendment #2                                                                     July 9, 2004
                                                                                                                Page 20 of 28

   RFP
              Question                                               DSHS Answer
 Reference
Appendix AA   Would State consider changing the time frame           Vendors should indicate any changes they desire to the
- 23.5        reference to within 6 months of first becoming aware   sample contract language in their Proposals per RFP Section
              of such?                                               5.5.
Appendix AA   Can Contractor use additional Subcontractors not       Yes, as long as the Contractor obtains prior written
- 23.28.1     proposed in its Response?                              permission from DSHS to use Subcontractor for specific
                                                                     services specified in their Response.
Appendix C    With regard to the definition of “knowledgeable” and   DSHS’s recurring monitoring process will consist of tracking
Item #12 &    “helpful” - what is the measuring tool that will be    complaints received by DSHS staff and periodic satisfaction
28            used for the assessments?                              surveys.
Appendix C    How is this measured? Are we responsible for LD’s      As indicated in requirement 4.26.2.10, the vendor is
Item #20      incurred by the reporting mechanism the individual     responsible for the performance after it is received and until it
              switch vendors? Should not [the vendor] only be        is released for delivery back to the switch vendor. No long
              responsible for response back to the network           distance or other communications link outside of the vendor
              demark?                                                data center are included in this performance measurement.
Appendix C    Is this based on “business” day or are you including   Unable to answer this questions because the RFP reference
Item #10      holidays and weekends? Current payments on             appears to be inconsistent with the question.
              legacy system for SSPS are daily and Medicaid is
              weekly. Does the Appendix C represent a change to
              the existing requirements?
General       Are there any components of the current MMIS that      No, assume that all existing MMIS components will be
              the agency would prefer to continue to utilize with    replaced per RFP Section 1.1.
              the new MMIS?
   Acquisition RFP No.0456-153 Amendment #2                                                                   July 9, 2004
                                                                                                             Page 21 of 28

  RFP
            Question                                                DSHS Answer
Reference
            We already got answers to a first set of questions      DSHS plans to release three (3) RFP amendments as
            like 6:00 yesterday. Do you expect to continue to do    follows:
            those in batches? What is the time frame that you        Amendment #1 – Posted on 6/24/04, revises the
            are going to use for posting "answers, or will we not       evaluation schedule and answers Bidder questions
            see another posting until the 19th?"                        received prior to June 23, 2004 2:00PM Pacific Time.
                                                                     Amendment #2 – To be posted on 7/9/04, will answer
                                                                        questions received after June 23, 2004 2:00PM Pacific
                                                                        Time, including those received at the Bidder’s
                                                                        Conference.
                                                                     Amendment #3 – To be posted on 7/19/04, will answer
                                                                        any additional questions received by 5:00 pm on July 16,
                                                                        2004.
                                                                    DSHS reserves the right to post additional amendments, if
                                                                    necessary.
            will you put forth a deadline for amending the RFP?     DSHS intends to post the last amendment as noted above on
                                                                    7/19/04. However, DSHS reserves the right to post additional
                                                                    amendments, if necessary.
            Could we have a copy of the vendor list of what         Please refer to the website referenced below for a list of
            everybody signed in today?                              Bidder Conference attendees:
                                                                    MMIS%20RFP%200456-
                                                                    153%20Bidder%20Conference%20Sign-in%20Sheet.pdf
   Acquisition RFP No.0456-153 Amendment #2                                                                    July 9, 2004
                                                                                                              Page 22 of 28

  RFP
            Question                                                 DSHS Answer
Reference
            I'm trying to break a log jam within our corporation     DSHS intends to adhere to the Intellectual Property and
            over a number of the questions that have been            source code laws in accordance with the CFRs referenced in
            submitted in the contracts and legal side of the         Appendix AA – Sample Contract (Agreement). DSHS
            procurement. What I would like to hear is someone        recognizes that differences in CFR interpretation are subject
            just explain to us in layman's terms here what your      to discussion and negotiation. However, since these are
            intent is with the source code issue and what rights     federal laws, there is a limit to what can be negotiated.
            to what source code and IP and those kinds of
            things that you are "really looking for. None of us in   See the Answer to the above Question referencing Appendix
            the room, I believe, are" "attorneys and are going to    AA – 8.2.
            go there, but I would like to just" hear it from your
            perspective what your expectations are in that
            regard. Fair enough?
            I wanted to know what phase you plan to implement        Phase 1 as defined in RFP Section 1.8.
            the" plastic I.D. cards in?
            Currently you have a network of Medicaid eligibility     The contracts for eligibility verification are between the
            verification contractors in the state that have been     current MMIS vendor and the eligibility verification vendors.
            there for years providing different types of             The intent is to give providers direct access to eligibility
            "technology, access to commercial payers, Medicaid       information via the web, IVR or swipe card solutions as
            and" "Medicare databases. My question is, do you         requested by the RFP. However, providers are free to
            intend to" continue to have that technology and that     contract with eligibility vendors, if they so choose.
            access to data available for providers in the state in
            addition to the POS terminals that are required in the
            RFP?
   Acquisition RFP No.0456-153 Amendment #2                                                                    July 9, 2004
                                                                                                              Page 23 of 28

  RFP
            Question                                                   DSHS Answer
Reference
            One more question. So just let me recap for my own         See response to the question regarding RFP Section 4.19
            understanding. You are going to implement a mag
            swipe card utilizing POS terminals that are part of
            the "RFP and for the contractor to provide to
            approximately 15,000" "providers, but you are also
            allowing for the current" infrastructure that already
            exists for additional "technologies, additional
            database access to continue in" conjunction with
            that. And here is my third question. So then I'll finish
            "up. Those 15,000 terminals that your intent is to
            put out" "there for the provider community, is the
            State planning on" furnishing those terminals to the
            providers in supporting "those transactions, or are
            the providers supposed to pay for" those terminals?
            The question I had was on the DSS side of it. I            Currently, the Fraud and Abuse Detection System (FADS) is
            notice that in the RFP that you are not asking for the     a separate contract from the MMIS with different expiration
            fraud and abuse detection system to be part of that.       dates. FADS is excluded from the MMIS Re-Procurement so
            Can you explain why that might be?                         that the 2 systems remain separate and independent of each
                                                                       other. This separation supports quality control of the MMIS
                                                                       data and recognizes that FADS is a specialized discipline
                                                                       with niche vendors in the marketplace.
            My question is that the RFP refers to a common             The common client and common provider components are
            client component and common provider component             currently in the planning stage by the DSHS Enterprise
            that are to be used as an interface with the MMIS.         Architecture Program (EAP). The intent is to use these
            Are these "already in existence, or what is the plan       components across DSHS where several systems, including
            to put them in" place?                                     MMIS, are able to access and use common client and
                                                                       provider IDs, and to cross-reference the common ID to an
                                                                       internal ID.
   Acquisition RFP No.0456-153 Amendment #2                                                                   July 9, 2004
                                                                                                             Page 24 of 28

  RFP
            Question                                                 DSHS Answer
Reference
            A follow-up question to that. Is there a particular      Different systems like the MMIS need to be independent of
            reason you still want all these different systems like   the component that generates common IDs for clients and
            the MMIS to have their own internal I.D.'s when you      providers. No systems will be allowed nor do they need to be
            are establishing a common I.D. for providers and         dependent upon the component that generates common
            clients?                                                 client or provider IDs.

            I have a specific question on the mars information.      In the current environment, HEDIS measures are reported
            You asked about current and future HEDIS                 by the health plans – any current requirements for DSS
            administrative reporting guidelines. Do you mean the     capability should be interpreted to mean “HEDIS-like
            precise NCQA definition of HEDIS or is your interest     measures”.
            in terms of what is generally referred to as "HEDIS-
            like capabilities? You have HEDIS listed there,          For future HEDIS reporting, CMS’ stated vision (Performance
            which" is a very precise NCQA trademark definition.      Measurement Partnership Project) is to develop a defined set
            Is that your intent? Because they have very precise      of required HEDIS measures that states would need to
            specific algorithm requirements in terms of their        submit annually, using administrative data. The National
            measures.                                                Committee for Quality Assurance’ (NCQA) Medicaid
                                                                     technical specifications for the measurement year and for the
                                                                     defined measures would have to be used without
                                                                     modification. Once CMS made needed programming
                                                                     changes in the Medicaid Statistical Information System
                                                                     (MSIS) to capture all of the necessary data (originally
                                                                     projected to occur in 2005), CMS stated that they “might”
                                                                     consider whether CMS or a CMS vendor could produce
                                                                     national aggregated reports and state-by-state comparisons
                                                                     directly from state submitted encounter data. Requirements
                                                                     and guidelines related to this future reporting is what is
                                                                     referred to in this DSS requirement.

                                                                     See RFP Section 4.16.4.3.
   Acquisition RFP No.0456-153 Amendment #2                                                                      July 9, 2004
                                                                                                                Page 25 of 28

  RFP
            Question                                                   DSHS Answer
Reference
            Is it realistic to assume that there won't be any paper    DSHS assumes paper claim volumes will decline eventually.
            claims of any kind in this new MMIS?                       However, current paper claims account for 15% of the claim
                                                                       volume for MMIS and 10% of the claim volume for SSPS.
            In the RFP there is a requirement in there for the         The requirement is to authenticate the IVR caller/user (see
            client to be able to utilize your IVR system. I think      RFP 4.18.6). Since the caller/user can be a client, we are
            for managed care enrollment is a variety of things.        looking for Bidders to propose a method of authentication.
            What sort of security are you envisioning to allow a
            client "to have access -- I mean, to interact with that
            system? With" "the provider their provider I.D. is
            typically edited, and" "that is the way, you know, that
            it's secured, but I'm just" curious in terms of a client
            using it.

            There is a schedule given on page 22 which talks           The schedule in the RFP reflects the state’s current thinking
            about two things happening in parallel. It talks about     and the assumption that system design and business
            a "design phase starting 1/18 going up to 9/15 of          analysis must occur in parallel due to 24-month DDI
            2005, and it" also talks about business process            schedule. DSHS expects Bidders to bring their expertise to
            analysis happening at the same time. Then it talks         the project and propose a schedule and work plan that
            about new business process definition. Right               supports both system design/development and human
            starting at 9/15. Is the assumption that these new         business process changes.
            business processes will be strictly based on a frozen
            design by 9/15. Is that a correct assumption?
            Because the schedule doesn't allow for any
            discrepancies between the new business processes
            and the design that has already been frozen.
   Acquisition RFP No.0456-153 Amendment #2                                                                   July 9, 2004
                                                                                                             Page 26 of 28

  RFP
            Question                                                 DSHS Answer
Reference
            Another question "related to schedule. The time line     Per RFP Section 1.3.4, CMS currently requires replacement
            here is -- you know, even" if you do a transfer and      of the MMIS by 12/30/06, allowing just 24 months for DDI.
            modify system where a system already "exists, there      Based on this schedule, DSHS divided design, development
            is always the requirements of the validation" phase.     and testing into three, 8-month segments. DSHS encourages
            Then you got a design phase which is about eight         Bidders to propose a recommended schedule and work plan
            months. I guess it includes requirements validation.     based on their expertise and knowledge. If Bidders think a 24
            There is also a gap analysis that you typically have     month schedule is unrealistic, they should identify an
            to do to see what the requirements are versus what       alternate schedule, keeping in mind that CMS needs to
            the base system offers. So given the timelines that      approve any deviations from a 24-month DDI period.
            you have and "then the development phase that just
            spans six months, is" this -- at least that is what we
            have on page 22. Unless the --
   Acquisition RFP No.0456-153 Amendment #2                                                                       July 9, 2004
                                                                                                                 Page 27 of 28

  RFP
            Question                                                    DSHS Answer
Reference
            I have a general question, John, that leads off of"         DSHS is interested in finding the best solution/approach to
            your flexibility that you seem to indicate in terms of      meet the stated business needs and requirements. However,
            the approach on the work plan. There are many               Bidders are cautioned that they must comply with all
            places in the RFP where you talk about your                 mandatory requirements (MR) and must adhere to technical
            business needs. My question is a general one. Are           standards and policies referenced in the RFP. DSHS also
            you looking to the vendors to come forth based on           recognizes that the state has had the same system in place
            our experience with the best solution to meet those         for over 20 years, which can limit the frame of reference for
            "business requirements, or do you want us to follow         the business representatives who developed the RFP
            the strict" requirements that you have laid out here        requirements.
            where you were -- in some cases you mandate or it
            appears to mandate specific "technical solution to
            approaches, which may not be the best" way to do it
            from the vendor's perspective. So you -- my general
            question goes to the "flexibility in your approach
            here. Are you laying out one," "two, three, four, five
            kinds of technical requirements that" "must be met,
            or is your interest in finding a vendor solution" that is
            going to meet the business requirements even
            though that may differ from those precise
            requirements as you laid them out?
            My question is on the sample contract and the               Per RFP Section 5.5 and 7.2.8, Bidders will be more
            clauses in the sample contract. How exactly is it if a      favorably evaluated based on the degree of acceptance of
            vendor modifies a term in the sample contract?              the proposed contract language in Appendix AA –Sample
            What is your criteria for determining how that is           Contract (Agreement). The score will be based on the degree
            going to be to weighed against? It says here don't          of proposed changes. The purpose of this requirement and
            modify these or anything. How are you going to              the scoring is to establish the starting point for negotiations
            evaluate that or assess that based on if somebody           and to gage how long negotiations will take. The more
            changes one line or rewrites the entire contract?           changes, the longer negotiations can take and the more
            How is that assessment going to be handled?                 adverse the impact on the overall schedule.
        Acquisition RFP No.0456-153 Amendment #2                                                  July 9, 2004
                                                                                                 Page 28 of 28

   RFP
                Question                               DSHS Answer
 Reference
7.2.7           General Information regarding Bidder   Per RFP Amendment #1, the Bidder evaluation schedule has
                Demonstrations                         been extended, primarily to accommodate Bidder
                                                       Demonstrations. Per RFP Section 7.2.7, selected finalists will
                                                       be invited to demonstrate how well the proposed system
                                                       meets the functional requirements. Finalists will be notified
                                                       on 9/3/04 and must be prepared to demonstrate system
                                                       functionality over 3 days with an oral presentation on the first
                                                       half of the 4th day. Demonstrations must follow DSHS
                                                       predefined scripts which will be made available to Bidders in
                                                       early August. The time slots reserved for Bidder
                                                       demonstrations and oral presentations are:
                                                        September 7 – 10, 2004
                                                        September 14 – 17, 2004
                                                        September 21 – 24, 2004

                                                       Any functionality that the proposed system currently does not
                                                       support must be demonstrated by other means (e.g.,
                                                       prototype, screen mock-up, process flow diagram, etc.).

				
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