Building and General Services of Vermont #03410-255-27

Independent audits of Vermont Health Connect

Vermont is seeking independent audit services for Vermont Health Connect, its State-Based Exchange. - Government buyer: State of Vermont, Agency of Human Services, Department of Vermont Health Access (DVHA); no specific office is identified. - Services requested: Five annual 45 CFR Part 155 programmatic and financial audits covering State Fiscal Years 2026–2030. - Review Marketplace receipts and expenditures for GAAP accounting, regulatory compliance, and controls intended to prevent improper eligibility determinations and enrollment transactions. - Identify errors that caused incorrect eligibility determinations and assess the control framework, financial and programmatic monitoring, APTC, privacy and security safeguards, and Quality Rating System measures and data. - Provide written financial and programmatic audit reports in accordance with applicable AICPA attestation standards and Government Auditing Standards; reports support annual submission to CMS and should address remedies for material weaknesses or significant deficiencies. - OEMs and vendors: No audit firm, OEM, or vendor is named. The contractor must be an independent CPA firm unaffiliated with the State Medicaid Agency. - Notable requirements: Annual financial reports are due in the spring, followed by programmatic compliance reports. The scope spans five state fiscal years; the anticipated contract structure is a two-year initial term with up to two additional 12-month renewal periods.

Description

The State of Vermont is seeking one or more contractors to perform programmatic and financial audits of Vermont Health Connect for State Fiscal Years 2026 through 2030. The work requires an independent CPA firm to conduct audits under applicable AICPA attestation standards and Government Auditing Standards and report on compliance with 45 CFR Part 155. The audits must address marketplace receipts and expenditures, regulatory compliance, processes to prevent improper eligibility determinations and enrollment transactions, and errors resulting in incorrect eligibility determinations. The anticipated contract term is two years, with options for up to two additional 12-month renewals.

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