RFP 18693 Virginia Fiscal Agent Services (FAS)

Background
The Department of Medical Assistance Services (DMAS) of the Commonwealth of Virginia is issuing this Request for Proposals (RFP) to obtain one Contractor for Fiscal Agent Services (FAS), previously known as the Medicaid Management Information System (MMIS) Solution.

The goal is to transform business processes and replace legacy FAS services, enhancing DMAS's operational capabilities in line with future technological and process advancements recommended by CMS, DMAS, or industry standards.

DMAS administers the Medicaid program under Title XIX of the Social Security Act and the Children's Health Insurance Program (CHIP) for over 2 million low-income Virginians.

Work Details
The Contractor will provide a comprehensive Fiscal Agent Services Solution that includes:
- Call center services to address inquiries from Medicaid members and providers.
- Implementation of advanced technologies such as Artificial Intelligence for improved workflows, decision-making, documentation, analytics, and customer support.
- Development of Progressive Web Apps (PWAs) for enhanced user experience across platforms.
- Database platforms for data collection, cleansing, transformation, and analysis to improve decision-making processes.
- Application development using low-code solutions to adapt quickly to changing business rules without extensive custom coding.
- Integration capabilities through Application Programming Interfaces (APIs) with other systems.
- Utilization of Natural Language Processing and Machine Learning technologies for system processing.

Additionally, the solution should support the MITA 3.0 Framework and include a continuous improvement plan.

Period of Performance
The contract will have a period of performance lasting six (6) years for Operations and Maintenance (O&M) following the successful completion of Design, Development, and Implementation (DDI), with options for up to three (3) renewal periods of up to 24 months each.

Place of Performance
The services will be performed at the DMAS central office located at 600 East Broad Street, Richmond, Virginia 23219.