Medicaid Information Technology Architecture State Self-Assessment & Related Svc

REQUEST FOR PROPOSALS FOR PROFESSIONAL SERVICES
MEDICAID INFORMATION TECHNOLOGY ARCHITECTURE (MITA) STATE SELF-
ASSESSMENT (SS-A) AND RELATED SERVICES
ISSUED BY THE DEPARTMENT OF HEALTH & SOCIAL SERVICES,
DIVISION OF MEDICAID AND MEDICAL ASSISTANCE
RFP NUMBER HSS-26-081
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TABLE OF CONTENTS
1. OVERVIEW ................................................................................................................. 3
2. SCOPE OF SERVICES .................................................................................................... 4
3. REQUIRED INFORMATION ............................................................................................. 8
4. PROFESSIONAL SERVICES RFP ADMINISTRATIVE INFORMATION ............................................ 9
5. CONTRACT TERMS AND CONDITIONS ............................................................................ 20
6. RFP MISCELLANEOUS INFORMATION ............................................................................ 38
7. ATTACHMENTS ......................................................................................................... 39
APPENDIX A: MINIMUM MANDATORY SUBMISSION REQUIREMENTS ......................... 51
APPENDIX B: TECHNICAL REQUIREMENTS ................................................................. 52
APPENDIX C: REQUIRED FORMS ................................................................................. 53
APPENDIX D: TEMPLATES/SAMPLE AGREEMENTS ..................................................... 54
APPENDIX E: DELIVERABLE & MILESTONE COST SCHEDULE ...................................... 55
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1. Overview
The State of Delaware Department of Health and Social Services, Division of Medicaid and Medical
Assistance, seeks professional services The purpose of this Request for Proposal (RFP) is to solicit
proposals from qualified contractors to provide Medicaid Information Technology Architecture (MITA)
State Self-Assessment (SS-A) and related activities for the Department of Health and Social Services
(DHSS), Division of Medicaid and Medical Assistance (DMMA), in compliance with the 21st Century
Cures Act (Cures Act) and applicable federal and state requirements. This request for proposals
("RFP") is issued pursuant to 29 Del. C. 6981 and 6982.
The proposed schedule of events subject to the RFP is outlined below:
Public Notice: July 2, 2026
Deadline for Questions: July 30, 2026, 4:30 PM EDT
Mandatory Pre-Bid Meeting: August 13 2026, 1:00 PM EDT
Response to Questions Posted: August 27, 2026
Deadline for Receipt of Proposals: September 17 2026, 1:00 PM EDT
Estimated Notification of Award: November 12, 2026
Estimated Project Start Date: January 1, 2027
Each proposal must be accompanied by a transmittal letter which briefly summarizes the proposing
firm's interest in providing the required professional services. The transmittal letter must also clearly
state and justify any exceptions to the requirements of the RFP which the applicant may have taken in
presenting the proposal. (Applicant exceptions must also be recorded on Attachment 4 of Appendix
C).
Furthermore, the transmittal letter must attest to the fact, at a minimum, that the Vendor shall not
store or transfer non-public State of Delaware data outside of the United States.
For technology related solicitations, Vendors may refer to the Delaware Department of Technology
and Information identified terms and conditions included in this solicitation.
The State of Delaware reserves the right to deny any and all exceptions taken to the RFP requirements.
1.1. Mandatory Prebid Meeting
A mandatory pre-bid meeting has been scheduled for August 13 2026, 1:00 PM EDT .
This is a mandatory meeting. If a Vendor does not attend this meeting, they shall be disqualified and
shall not be considered for further evaluation.
________________________________________________________________________________
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Meeting ID: 256 309 142 332 76
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________________________________________________________________________________
Questions may be submitted no later than July 30, 2026.
All inquiries must be submitted in the Q/A section of the project listing in the Euna Procurement
(formerly titled Bonfire) Portal.
The Department's response to questions will be posted, according to the procurement schedule,
under the project listing in Euna Procurement (formerly Bonfire) and to the State of Delaware Bid
Solicitation Directory website by August 27, 2026.
2. Scope of Services
As part of the initiative, the State is required to perform an annual State Self-Assessment (SS-A) based
on the Medicaid Information Technology Architecture (MITA) 3.0 framework, assuring alignment and
progress toward Centers for Medicare and Medicaid Services (CMS) objectives. These assessments are
extensive; measuring "as is" and "to be" maturity levels in the categories of "7 Standards and
Conditions" (Modularity, MITA, Industry Standards, Leverage, Business Results, Reporting,
Interoperability), business architecture, information architecture, and technical architecture. In total
there are nearly 1,000 checklist items to assess across various business and technical areas, involving
many subject matter experts (SME).
The Vendor will provide a Software as A Service (SaaS) SAAS tool to assist the State of Delaware to
complete and submit the annual Centers for Medicare and Medicaid Services (CMS) Medicaid Information
Technology Architecture State Self-Assessment (MITA SS-A). The vendor will configure and maintain the
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tool. In addition, the Vendor will provide consulting support services, and introduce a sustainable design
and approach for ongoing MITA SS-A submission. The contract will require the Vendor to cooperate with
the ordering agency to ensure the State receives the most current state-of-the-art material and/or
services.
This RFP is looking for a SaaS tool with strong consulting and staffing services. There will be no systems
or systems modules purchased or developed. The Vendor shall provide all equipment, materials and
labor to lead and supplement the State of Delaware's needs for Centers for Medicare and Medicaid
Services (CMS) Medicaid Information Technology Architecture State Self-Assessment (MITA SS-A) Annual
Submission(s) as described herein.
2.1. Department of Health and Social Services (DHSS)
The mission of DHSS is to improve the quality of life for Delaware's citizens by promoting health and
well-being, fostering self-sufficiency, and protecting vulnerable populations. DHSS is comprised of
eleven divisions as follows:
* Division of Substance Abuse and Mental Health
* Division of Child Support Services
* The Delaware Health Care Commission
* Division of Health Care Quality
* Office of the Secretary-Administration
* Division of Developmental Disabilities Services
* Division of Public Health
* Division of Services for Aging and Adults with Physical Disabilities
* Division of Social Services
* Division of Medicaid and Medical Assistance
* Division for the Visually Impaired
2.2. The Division (Ordering Agency)
Division of Medicaid and Medical Services (DMMA) is Delaware's Single State Medicaid agency. Its
mission is to improve health outcomes by ensuring that the highest quality medical services are
provided to the vulnerable populations of Delaware in the most cost-effective manner.
As of February 2022, approximately 234,000 members were enrolled in Delaware's Medicaid program.
Approximately seventy nine percent (79%) of those enrolled receive their services through the
managed care plans under Delaware's Diamond State Health Plan (DSHP), six percent (6%) receive
their services through the State's managed long-term services and supports program (Diamond State
Health Plan Plus (DSHP-Plus)) and 15% receive their services through the State's Medicaid fee-for-
service (FFS) program.
2.3. DMMA Information Systems Unit (ISU)
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The DMMA ISU is a dedicated unit in the Division responsible for managing Medicaid systems projects
including the Medicaid Enterprise System (MES) and related initiatives and Health Information
Technology funded projects. This RFP and contract will be primarily managed by ISU.
2.4. MITA Initiative
The Medicaid Information Technology Architecture (MITA) initiative sponsored by the Center for
Medicare and Medicaid Services (CMS) and governed by the MITA Governance Board is intended to
foster integrated business and information technology (IT) transformation across the Medicaid
enterprise to improve the administration of the Medicaid program.
The MITA Initiative is a national framework to support improved systems development and health care
management for the Medicaid enterprise. MITA has a number of goals, including:
* development of seamless and integrated systems that communicate effectively through
interoperability, and
* common standards and processes.
MITA promotes:
* flexibility,
* adaptability, and
* rapid response to changes in programs and technology.
The MITA enterprise view supports technologies that align with Medicaid business processes and
enable coordination with public health and other partners, including human services. MITA is
continually updated in response to developing program policies and goals.
CMS affirmed the overarching MITA 3.0 Framework with our final rule at 42 CFR Part 433 titled,
Medicaid Program: Federal Funding for Medicaid Eligibility Determination and Enrollment Activities,
Final Rule (Federal Register, Vol. 76, No.75) effective April 19, 2011. This rule provides states with the
opportunity to receive enhanced Federal funding in order to improve interaction and interoperability
across the Medicaid Enterprise. The rule requires that states complete a SS-A to help determine their
"as is" environment across the Medicaid Enterprise.
MITA helps States prepare the MITA State Self-Assessment (SS-A) and Roadmap and to develop
enterprise architectures to align to and advance increasingly in MITA maturity for business,
architecture, and data.
The MITA Framework is a consolidation of principles, models, and guidelines that combine to form a
template for the States to use to develop their own enterprise architecture. MITA processes provide
guidance for State Medicaid Enterprise to use in adopting the MITA Framework through shared
leadership, collaboration, and reuse of solutions.
The MITA Framework for the Medicaid Enterprise includes the following:
* Part I - Business Architecture: defines business activity and maturity determinations.
* Part II - Information Architecture: defines data relationships and industry standards to support
business activity.
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* Part III - Technical Architecture: defines sets of business and technical services, their
connectivity, and standards to support Part I and II.
Each of the architectures aligns with the Seven Standards and Conditions (7S&C) which CMS has
issued and expects States to adhere to in order for Medicaid technology investments (including
eligibility systems, as well as traditional claims processing systems) to be eligible for enhanced federal
matched funds.
The Seven Standards and Conditions consist of the following:
* Modularity Standard - Uses a modular, flexible approach to systems development, including
the use of open interfaces and exposed Application Programming Interfaces (API); the
separation of standardized business rule definitions from core programming; and the
availability of standardized business rule definitions in both human and machine-readable
formats. The States commit to formal system development methodology and open, reusable
system architecture.
* MITA Condition - States align to and advance increasingly in MITA maturity for business,
architecture, and data.
* Industry Standards Condition - Ensures alignment with, and incorporation of, industry
standards: the Health Insurance Portability and Accountability Act of 1996 (HIPAA) security,
privacy and transaction standards; accessibility standards established under section 508 of the
Rehabilitation Act, or standards that provide greater accessibility for individuals with
disabilities, and compliance with Federal Civil Rights laws; standards adopted by the Secretary
under section 1104 of the Affordable Care Act; and standards and protocols adopted by the
Secretary under section 1561 of the Affordable Care Act.
* Leverage Condition - State solutions should promote sharing, leverage, and reuse of Medicaid
technologies and systems within and among States.
* Business Results Condition - Systems should support accurate and timely processing of claims
(including claims of eligibility), adjudications, and effective communications with providers,
beneficiaries, and the public.
* Reporting Condition - Solutions should produce transaction data, reports, and performance
information that contributes to program evaluation, continuous improvement in business
operations, and transparency and accountability.
* Interoperability Condition - Systems must ensure seamless coordination and integration with
the Exchanges (whether run by the state or federal government), and allow interoperability
with Health Information Exchange (HIE), public health agencies, human services programs,
and community organizations providing outreach and enrollment assistance services.
2.5. DMMA's SS-A History
The SS-A supports the MITA Framework because it compares our business operations to the MITA
business process model, identifies system solutions and how they support the business, and how data
is shared and managed. The intent of completing an annual SS-A is to allow DMMA to better
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understand our operations, assists with strategic planning, and measure our progress towards the
future and a stronger IT maturity. Finally, the SS-A is a resource for completing federal regulatory
documents throughout the year.
DMMA's last full SS-A (3.0) was completed in 2022 and incorporated our newly implemented Medicaid
Management Information System (MMIS) titled Delaware Medicaid Enterprise system (DMES). Prior to
the implementation of DMES we were at a MITA Maturity Level (MML) of Level 1. Level 1 is defined as
the agency focuses on meeting compliance thresholds dictated by state and federal regulations and
processes are primarily manual. Since 2022 we have updated our MITA SS-A annually and we are
consistently at a MITA Maturity Level (MML) of Level 2. Level 2 is defined as improvement over Level 1
and includes both manual and automated processes.
Our MITA Roadmap is a five-year plan describing planned activities and enhancements that will
improve Delaware Medicaid's MITA maturity. DMMA is committed to advancing its overall MITA
Maturity from Level 2 to Level 3 over the next ten years by transitioning to a modular Medicaid
Enterprise System (MES).
Therefore, DMMA is releasing this RFP to contract with a vendor who will provide a hosted SaaS
solution to streamline the annual federal MITA Self-Assessment process as well as lead the State in
successful annual MITA SS-A submission.
3. Required Information
The following information shall be provided in each proposal in the order listed below. Failure to
respond to any request for information within this proposal may result in rejection of the proposal at
the sole discretion of the State.
3.1. Minimum Requirements
a. Provide Delaware license(s) and/or certification(s) necessary to perform services as identified
in the scope of work.
b. Prior to the execution of an award document, the successful Vendor shall either furnish the
Agency with proof of State of Delaware Business Licensure or initiate the process of application
where required.
c. Vendor shall provide responses to the Request for Proposal (RFP) scope of work and clearly
identify capabilities as presented in the General Evaluation Requirements below.
d. Complete all appropriate attachments and forms as identified within the RFP.
e. Proof of insurance and amount of insurance shall be furnished to the Agency prior to the start
of the contract period and shall be no less than as identified in the bid solicitation, Section
5.7.8, Insurance.
3.2. General Evaluation Requirements
a. Familiarity and experience creating and running similar projects.
b. MITA SS-A solution maturity and functionality
c. Performance including timeliness, company oversight, and on-going project support and
maintenance.
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d. Qualified and experienced professionals in Medicaid Enterprise Systems.
e. References.
f. Other criteria necessary for a quality cost-effective project
4. Professional Services RFP Administrative Information
4.1. RFP Issuance
4.1.1. Public Notice
Public notice has been provided in accordance with 29 Del. C. 6981.
4.1.2. Obtaining Copies of the RFP
This RFP is available in electronic form through the State of Delaware Procurement website and
on Euna Procurement (formerly Bonfire).
Paper copies of this RFP will not be available.
4.1.3. Assistance to Vendors with a Disability
Vendors with a disability may receive accommodation regarding the means of communicating this
RFP or participating in the procurement process. For more information, contact the Designated
Contact no later than ten days prior to the deadline for receipt of proposals.
4.1.4. RFP Designated Contact
All requests, questions, or other communications about this RFP shall be made through Euna
Procurement (formerly Bonfire).
Communications made to other State of Delaware personnel or attempting to ask questions by
phone or in person will not be allowed or recognized as valid and may disqualify the vendor.
Vendors should rely only on written statements issued by the RFP designated Contracts,
Management and Procurement contact.
The RFP designated contact is:
Samantha Somers
Management Analyst III
Samantha.Somers@Delaware.gov
Contracts, Management and Procurement Contact:
Eddie Mui
Management Analyst III
DHSS_DMS_DMSProcure@Delaware.gov
4.1.5. Consultants and Legal Counsel
The State of Delaware may retain consultants or legal counsel to assist in the review and
evaluation of this RFP and the vendors' responses. Bidders shall not contact the State's consultant
or legal counsel on any matter related to the RFP.
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4.1.6. Contact with State Employees
Direct contact with State of Delaware employees other than the State of Delaware Designated
Contact regarding this RFP is expressly prohibited without prior consent. Vendors directly
contacting State of Delaware employees risk elimination of their proposal from further
consideration. Exceptions exist only for organizations currently doing business in the State who
require contact in the normal course of doing that business.
4.1.7. Organizations Ineligible to Bid
Any individual, business, organization, corporation, consortium, partnership, joint venture, or any
other entity including subcontractors currently debarred or suspended is ineligible to bid. Any
entity ineligible to conduct business in the State of Delaware for any reason is ineligible to respond
to the RFP.
4.1.8. Exclusions
The Proposal Evaluation Team reserves the right to refuse to consider any proposal from a vendor
who:
a. Has been convicted for commission of a criminal offense as an incident to obtaining or
attempting to obtain a public or private contract or subcontract, or in the performance
of the contract or subcontract:
b. Has been convicted under State or Federal statutes of embezzlement, theft, forgery,
bribery, falsification or destruction of records, receiving stolen property, or other
offense indicating a lack of business integrity or business honesty that currently and
seriously affects responsibility as a State contractor:
c. Has been convicted or has had a civil judgment entered for a violation under State or
Federal antitrust statutes:
d. Has violated contract provisions such as;
1. Known failure without good cause to perform in accordance with the
specifications or within the time limit provided in the contract; or
2. Failure to perform or unsatisfactory performance in accordance with terms of
one or more contracts;
e. Has violated ethical standards set out in law or regulation; and
f. Any other cause listed in regulations of the State of Delaware determined to be serious
and compelling as to affect responsibility as a State contractor, including suspension or
debarment by another governmental entity for a cause listed in the regulations.
4.2. RFP Submissions
4.2.1. Acknowledgement of Understanding of Terms
By submitting a bid, each vendor shall be deemed to acknowledge that it has carefully read all
sections of this RFP, including all forms, schedules and exhibits hereto, and has fully informed itself
as to all existing conditions and limitations.
4.2.2. Proposals
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