Nevada ePro #41NHA-S4038

Nevada PACE site establishment and operation services

Nevada is seeking qualified organizations to launch and operate Program of All-Inclusive Care for the Elderly (PACE) sites for eligible older adults. - Government buyer: Nevada State Purchasing Division, on behalf of the Nevada Health Authority (NVHA), including Nevada Medicaid. - Opportunity: Establish and operate one or more PACE sites in Clark County, Washoe County, and/or all rural counties. Proposals must use these defined service areas. - Services requested: Integrated medical, behavioral health, social, and supportive care for eligible Medicaid recipients aged 55 or older who meet nursing-facility level-of-care criteria. Work includes program administration, participant eligibility and care, center operations, subcontractor oversight, information security, participant communications, grievances and appeals, fiscal controls, quality improvement, and reporting. - Sites and payment: Each center is limited to 300 participants unless NVHA increases the limit. Payment uses risk-based monthly capitation rates, with a 94% payment percentage. Rates stated in the solicitation are Clark County: $4,978.04 per month for Full Dual Eligibles and $8,385.06 for Non-Dual eligible individuals; Washoe County: $45,324.24 and $7,642.05, respectively; and all rural counties: $5,226.94 and $8,804.32, respectively. - Important requirements: Successful readiness review and Centers for Medicare & Medicaid Services (CMS) approval are required before services begin. Providers must furnish equivalent Nevada Medicaid Frail Elderly and Persons with Physical Disabilities waiver home- and community-based services, maintain a $1.5 million performance security deposit, and submit encounter data monthly. State data must generally be hosted in the United States; applicable GovRAMP risk-assessment requirements apply to cloud components. - Operational and insurance requirements: Maintain business continuity and disaster recovery plans, test plans and recovery systems at least annually, and ensure subcontractor compliance. Required insurance includes general liability, automobile liability, workers’ compensation/employers’ liability, and professional liability, with specified minimum limits and State of Nevada additional-insured protections. - Named OEMs and vendors: No commercial OEMs, product manufacturers, or vendors are named. No products, part numbers, or discrete product quantities are requested.

Description

The Nevada State Purchasing Division, on behalf of the Nevada Health Authority, seeks qualified vendors to establish and operate one or more PACE sites within the defined Nevada service areas. Services include integrated medical, behavioral health, social, and supportive care for eligible Medicaid recipients age 55 and older who meet nursing facility level-of-care requirements and live in the community. Contractors will provide the required services at established risk-based monthly capitation rates and are responsible for the costs of establishing fully operational PACE centers. The solicitation anticipates multiple awards; contractors must complete readiness review and obtain CMS approval before beginning services.

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