Agency Human Services Dept

Contractor Michigan Peer Review Organization (MPRO)

SWIFT Contract Number B21160

Project Name External Quality Review Compliance Project

Project Number (if applicable) N/A

Summarize purpose of the contract, including why it was necessary: The Minnesota Department of Human Services (DHS) must procure professional and technical consulting services of a qualified External Quality Review Organization (EQRO) to meet federal Medicaid requirements. EQRO professional and technical consulting services assisted in the design, implementation and management of an annual “External Quality Review of Managed Care Organizations” and reporting for calendar years 2008, 2009, 2010, 2011 and 2012. The annual review and reporting must be conducted to meet the requirements described in the 42 CFR 438 Subparts D and F and current DHS Medicaid managed care contract requirements. Since this is an ongoing federal requirement, to ensure continued federal financial matching funds, DHS used its discretion and entered into four annual extensions of the contract. The contract and annual extensions did not exceed five years.

These types of assessment activities must be conducted by a neutral, unbiased organization to assure all interested parties that those who may have authority for administering these programs did not influence findings and recommendations. MPRO was a qualified vendor meeting all qualifications to be an external quality review organization as outlined in Federal Regulation 42 CFR 438.354.

Project Duration

Start Date Fri, 10/31/2008 - 00:00

Original end date Wed, 10/30/2013 - 00:00

Actual end date Wed, 10/30/2013 - 00:00

Did project finish on time? Yes

Total billable hours utilized (if applicable) {Empty}

Contract Amounts

Original contract: $155591.00

Amendments $686543

Contract total $842134.00

Did project finish within budget? Yes

What was the funding source? State and Federal

Is this a sole source contract? No

If this was a single source contract, explain why the agency determined there was only a single source for the services (if applicable) {Empty}

Evaluator Name Robert Lloyd

Evaluator Email Address Robert.Lloyd@state.mn.us

Evaluate the contractor's timeliness The EQRO was willing to work within the confines of the State’s ability to provide data for review and still comply with the resulting tight deadlines. Monthly reports and the project work plan were complete and on time.

Evaluate the contractor's quality MPRO’s annual review and report was conducted to meet the requirements described in 42 CFR 438 Subparts D and F and current DHS Medicaid managed care contract requirements.
Staff was knowledgeable regarding the MCO’s Quality Assessment and Performance Improvement Program; offering technical assistance to an MCO in redesigning its Quality Work Plan based on a template designed by MPRO. The final ATR was a comprehensive review of the MCOs’ performance.

Evaluate the contractor's cost Cost was reasonable – stayed within the budget and did not spend the full certification amount.

Evaluate the contractor's overall performance MPRO produced quality deliverables and answered all questions related to quality, timeliness and access to health care services that managed care organizations (MCO) furnished to Minnesota’s publicly funded managed care enrollees. Commitment to meeting customer expectations in the production of a quality product is their greatest strength.

Would you engage the contractor's services again? Yes

Describe any negative action taken during the duration of this contract (i.e., termination, pursuit of suspension, etc.): None

Please rate the overall experience with the contractor 5 - very satisfied