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RFP Developement SLA Consultant
(Jobs in Bismarck, ND)
 
Requirement id 113256
Job title Consultant
Job location in Bismarck, ND
Skills required Application Programming, Project Systems, Financial Experience, RFP Developement SLA
Open Date 22-Jan-2021
Close Date
Job type Contract
Duration 12 Months
Compensation DOE
Status requirement ---
Job interview type ---
   Email Recruiter: coolsoft
Job Description Consultant: Application Programming, Project Systems, Financial Experience, RFP Developement SLA

Start Date :05/24/2021

Submission Deadline :02/17/2021 12:00 PM CT

Client Info : State Procurement Office

Description :

SECTION THREE – SCOPE OF WORK

SCOPE OF WORK:

The STATE is soliciting proposals for a fully integrated Patient Access and Provider Directory API with Medicaid Management Information System (MMIS) that will give patients access to their health information and move the healthcare system toward greater interoperability. These APIs are required to be developed utilizing Health Level 7® (HL7) Fast Healthcare Interoperability Resources® (FHIR) Release 4.0.1 as the foundational standard to support data exchange via secure APIs. The development, design, and implementation of these APIs must also comply to all federal requirements outlined under CMS-9115-F of the Federal Registry. Current CMS Federal deadline is July 1, 2021; however, the STATE has not targeted a go-live date with CMS. STATE may have the option to file for a good faith effort request waiver if the implementation does not meet the July 1, 2021 deadline. Offerors are asked to consider this deadline when completing proposed schedule below.
The awarded Offeror will be required to enter into Attachment 7 – Business Associate Agreement.

As stated and published by CMS, the below information is a high-level overview for each API.
Patient Access API:
The final rule requires MA organizations, Medicaid and CHIP FFS programs, Medicaid managed care plans, CHIP managed care entities, and QHP issuers on the FFEs to implement and maintain a standards-based Patient Access API. This Patient Access API must meet the technical standards finalized by HHS in the ONC 21st Century Cures Act final rule at 45 CFR 170.215 (currently including Health Level 7® (HL7) Fast Healthcare Interoperability Resources® (FHIR) Release 4.0.1) and the content and vocabulary standards finalized by HHS in the ONC 21st Century Cures Act final rule at 45 CFR 170.213, as well as content and vocabulary standards at 45 CFR part 162 and the content and vocabulary standards at 42 CFR 423.160. Through the Patient Access API, payers must permit third-party applications to retrieve, with the approval and at the direction of a current enrollee, data specified at 42 CFR 422.119, 431.60, 457.730, and 45 CFR 156.221. Specifically, we are requiring that the Patient Access API must, at a minimum, make available adjudicated claims (including provider remittances and enrollee cost-sharing); encounters with capitated providers; and clinical data, including laboratory results (when maintained by the impacted payer), information about covered outpatient drugs and updates to such information, including, where applicable, preferred drug list information. Data must be made available no later than one (1) business day after a claim is adjudicated or encounter data are received.

Provider Directory API:
The final rule requires that MA organizations, Medicaid and CHIP FFS programs, Medicaid managed care plans, and CHIP managed care entities make standardized information about their provider networks available through a Provider Directory API that is conformant with the technical standards finalized by HHS in the ONC 21st Century Cures Act final rule at 45 CFR 170.215, excluding the security protocols related to user authentication and authorization and any other protocols that restrict availability of this information to particular persons or organizations. Authentication and authorization protocols are not necessary when making publicly available data accessible via an API. The Provider Directory API must be accessible via a public-facing digital endpoint on the payers website to ensure public discovery and access. At a minimum, these payers must make available via the Provider Directory API provider names, addresses, phone numbers, and specialties. For MA organizations that offer MA-PD plans,
 
Call 502-379-4456 Ext 100 for more details. Please provide Requirement id: 113256 while calling.
 
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(Consultant: Application Programming, Project Systems, Financial Experience, RFP Developement SLA in Bismarck, ND)
     
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