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April 13, 2018 Dear Applicant: This letter is to announce the release of this Request for Applications (RFA) for the purpose of obtaining one qualified individual specialized in the field of personal injury valuation to provide expert witness services to the Ohio Department of Medicaid’s Office of Legal Counsel. The State Medicaid program has an automatic right of recovery when a Medicaid recipient is injured by a third party(s) and the recipient is successful in obtaining monies from that third party(s) for the cost of medical assistance. The amount of recovery is governed by standards specified in the Ohio Revised Code. The Ohio Department of Medicaid seeks to obtain its own expert in this area to provide written reports based upon their knowledge and attend hearings when required. This RFA document is released by ODM, if ODM issues an award as a result of this RFA, the contract will be between the applicant and ODM. If you are interested in submitting a response for this important project, please obtain the RFA through ODM’s Web Page at: www.medicaid.ohio.gov, and following these instructions: * Under the Resources tab * Go Down to Legal and Contracts * Select RFPs in the drop-down menu * Click the Link to the actual RFA If you experience problems opening the above referenced ODM URL, please contact the ODM Office of Contracts and Procurement at the following telephone number: (614) 752-5284. Again, responses must be prepared and submitted in strict accordance with the requirements and time frames given in the RFA. Thank you for your attention to this request. Sincerely, //SIGNED// Jessica Gaston Mathews, Esq. Deputy Legal Counsel Office of Contracts and Procurement JGM/dls

http://www.medicaid.ohio.gov/

Ohio Department of Medicaid

Request for Applications RFA: ODMR-1819-1014

SECTION I. Purpose The Ohio Department of Medicaid (ODM) is soliciting applications to identify one qualified individual specialized in the field of personal injury valuation to provide expert witness services to ODM’s Office of Legal Counsel. The State Medicaid program has an automatic right of recovery when a Medicaid recipient is injured by a third party(s) and the recipient is successful in obtaining monies from that third party(s) for the cost of medical assistance. The amount of recovery by ODM is governed by the standards specified in the Ohio Revised Code (ORC) § 5160.37(G). A recipient may rebut the amount recovered by ODM by requesting a hearing in accordance with ORC § 5160.37(L). In some cases, recipients acquire the services of attorneys or other professionals with significant personal injury experience to help determine the value of the case, absent the liability insurance policy limits. ODM seeks to obtain its own expert for these purposes. This Request for Applications (RFA) document is released by ODM, if ODM issues an award as a result of this RFA, the contract will be between the applicant and ODM. Applicants responding to this RFA are not required to be attorneys, but must possess knowledge of the judicial system, and have extensive experience with the ways in which courts, insurance carriers, and attorneys value personal injuries. ODM will designate a staff member as the ODM Contract Manager to provide on-going supervision of the Contractor selected through this RFA. The contract period for this project is expected to run from approximately July 1, 2018 through June 30, 2019. Any contract renewal options are at the sole discretion of ODM. ODM will only accept applications from suppliers that demonstrate the capability of providing services as described in this RFA. For the purpose of this RFA, the term “supplier” and “applicant” shall be defined as an organization or individual interested in this opportunity. The term “Contractor” is used in reference to the successful applicant selected through this RFA. ODM is under no obligation to enter into a contract with any supplier as a result of this solicitation. Changes in this RFA of a material nature will be provided on the agency website. All suppliers are responsible for obtaining any such changes and will not receive notice of any changes from ODM. If you are interested in submitting an application to this RFA, please follow the procedures stipulated in Section II of this RFA. SECTION II. Time/Date and Format of Submission Organizations, companies, firms, or individuals who are interested in submitting applications must make their submission no later than 11:59 p.m. Eastern (local) Time May 14, 2018. Supplier applications for RFAs must be submitted by email to the following address: [email protected]. All completed submissions must be received by ODM by the above date and time. Materials received after the submission deadline date will not be added to applications. ODM is not responsible for applications not received due to technical issues that prevent delays in the receipt of applications. Suppliers must convert electronic submissions into one .pdf document. If the submission’s size necessitates more than a single .pdf document to contain the entire application, please use the fewest separate .pdf documents

mailto:[email protected]

ODMR-1819-1014 Legal Expert Witness pg. 2 of 7

possible. The supplier’s total application submission must be received by the Office of Contracts and Procurement (OCP) in accordance with this Section. All applications must contain the supplier’s name, the RFA number, and the submission date. Submission of an application indicates acceptance by the supplier of the conditions contained in this RFA, unless clearly and specifically noted in the application submitted and confirmed in the contract between ODM and the supplier selected. SECTION III. Anticipated Procurement and Project Timetable

April 13, 2018

ODM releases RFA on ODM and DAS Web Sites; Q&A period opens. Suppliers may submit inquiries for RFA clarification.

April 30, 2018

Supplier Q & A Period closes, 8 a.m. for inquiries for RFA clarification - No further inquiries for RFA clarification will be accepted.

May 14, 2018

Deadline for suppliers to Submit Applications to ODM (11:59 p.m. Eastern (local) Time).

May 31, 2018 ODM Issues Contractor Selection Notification Letter (estimated)

July 2 , 2018 Contract effective date/Purchase Order approval – work may not begin until a state Purchase Order has been issued (Estimated Date).

May be renewed for up to two biennium periods.

Contract terminates at the end of the 2019 State Fiscal Year, or June 30, 2019. This contract may be renewed until June 30, 2023.

ODM reserves the right to revise this schedule if needed and/or to comply with the State of Ohio procurement procedures and regulations. In accordance with Ohio Revised Code (ORC) § 126.07, ODM contracts are not valid and enforceable until the Office of Budget and Management (OBM) certifies the availability of appropriate funding, as indicated by the approval of the Purchase Order (PO). The selected supplier may neither perform work nor submit an invoice for payment for work performed for this project for any time period prior to the PO approval date. ODM will notify the selected supplier when the requirements of ORC § 126.07 have been met and send them a copy of the PO. The initial contract period will be approximately from July 2, 2018 through June 30, 2019, with the possibility for two renewal contracts that would be in effect from July 1, 2019 through June 30, 2021, and July 1, 2021 through June 30, 2023, contingent upon satisfactory performance, continued availability of funding, and all required approvals. Renewal may be subject to approval by ODM and the Controlling Board. SECTION IV. Internet Question and Answer Period; RFA Clarification Opportunity Suppliers or other interested parties may ask clarifying questions regarding this RFA via the Internet during the Q&A Period as outlined in Section III, Anticipated Procurement Timetable. To ask a question, suppliers must use the following Internet process:

1. Access the ODM Web Page at http://medicaid.ohio.gov; 2. Go to the “Resources” tab and select “Legal and Contracts”; 3. Select “RFPs”, under “Current Opportunities”, select the appropriate RFA; 4. Select the “Submit Inquiry” option button; and 5. Provide requested information and submit question.

http://medicaid.ohio.gov/


Questions about this RFA must reference the relevant part of this RFA, the heading for the provision under question, and the page number where the provision can be found. The name of a representative of the supplier (or other interested party), the company name, phone number, and e-mail address must be provided to submit an inquiry. ODM may, at its option, disregard any questions which do not appropriately reference an RFA provision or location within the RFA, or which do not include identification of the originator of the question. Questions submitted after 8:00 a.m. on the date the Q&A period closes will not be answered. ODM will not provide answers directly to any party that submitted questions. ODM’s responses to all questions will be posted on the Internet website dedicated to this RFA, for public reference by any interested party. ODM will not answer questions received in any other manner than that which is described in this RFA. Questions submitted may be no more than 4,000 characters in length, but there is no limit on the number of questions that may be submitted. ODM’s answers may be accessed by following the instructions above, but rather than selecting “Submit Inquiry,” Suppliers and others should select “View Q and A.” ODM strongly encourages Suppliers to ask questions early in the Q&A period so that answers can be posted with sufficient time for any possible follow-up questions. Supplier applications in response to this RFA are to take into account any information communicated by ODM in the Q&A process for the RFA. It is the responsibility of all suppliers to check this site on a regular basis for responses to all questions, as well as for any amendments, alerts, or other pertinent information regarding this RFA. Accessibility to questions and answers are clearly identified on the website dedicated to this RFA once submitted questions have been answered. Requests for copies of any previous RFAs or for past supplier applications, score sheets or contracts for this or similar past projects, are Public Records Requests (PRRs) and should be submitted to: [email protected]. Please Note: PRRs are not a part of the RFA Q&A process and OCP cannot dictate the timeline for a response of these requests. SECTION V. Qualifications Mandatory Applicant Qualifications and Capabilities: In order to be considered for the project described in this RFA, ODM requires that interested applicants must meet, at minimum, all the following qualification requirements and provide all requested documentation:

1. Submission of application on or before the specified deadline as stated in Section II., of this RFA;

2. Have at least ten (10) years of experience as a personal injury attorney, including valuation of personal injury cases, OR have at least five (5) years of experience as an insurance adjuster reviewing, analyzing, and valuing insurance adjustment claims. There is a preference for individuals who have previously served as expert witnesses in litigation on the subject of valuation of personal injury cases;

3. Submission of one writing sample, not to exceed six (6) pages, as an example of the applicant’s work product in evaluating the value of a personal injury case. The writing sample should include, at a minimum a description of the injury involved, the factors considered to determine valuation, and the analysis performed. The writing sample will be graded on a scale of 1-10 based on grammar, clarity, and methodology; and

mailto:[email protected]


4. Submission of signed Attachment A forms: A1- Required Vendor Information, A2 - Vendor and Grantee Ethics Certification, and A3 – Location of Business and Offshore Business Declaration Form by affirming the following: a. The review and understanding of Ohio ethics and conflict of interest laws, as found in Chapter 102 102 and §§ 2921.42 and 2921.43 of the ORC; b. Confirmation of not being excluded from entering into a contract with ODM due to restrictions related to the federal debarment list, unresolved findings under ORC § 9.24 and unfair labor findings pursuant to ORC § 121.23;

c. Compliance with the requirement to maintain a complete affirmative action plan, or accept the State’s plan, and be in compliance with ORC § 125.111 prior to being awarded a contract. Suppliers should review these requirements at the following DAS website: http://das.ohio.gov/Divisions/EqualOpportunity/AffirmativeActionEqualEmploymentOpportunity.aspx; and

d. Acknowledgement that, pursuant to ORC § 9.76, a state agency may not enter into or renew a contract for supplies, equipment or services with a company that operates to earn a profit unless that company certifies that it is not boycotting any jurisdiction with whom the State of Ohio can enjoy open trade. Supplier agrees to notify ODM immediately if it boycotts a jurisdiction with whom the State of Ohio can enjoy open trade.

Failure to meet the above requirements will result in disqualification from consideration for an award. Sensitive Personal Information: It is the responsibility of the supplier submitting an application to remove all personal confidential information (such as social security numbers) from any other part of the application package. Following submission to ODM, all applications submitted become part of the public record. Any supplier who provides this information may be disqualified. SECTION VI. Scope of Work Contractor will be responsible for providing expert witness services by reviewing and analyzing materials from Medicaid recipients’ case files that were awarded a lump sum compensation from a third party due to an injury. Contractor will be relied upon to establish a value that takes into account the requirements described in ORC § 5160.37(G), and will prepare reports of findings upon completion of their review, and the reasons therefore. Contractor will be required to provide testimony on an as needed basis. Most adjudication hearings held before ODM are conducted in Columbus, Ohio which will serve as the headquarters for purposes of the contract. Therefore, there shall be no reimbursement available for expenses incurred in travel to the headquarters. However, if additional travel is required by ODM, reimbursement for travel and other related expenses are subject to the limits established pursuant to ORC §§ 126.31 and 126.32 and which are set forth in rule 126-1-02 of the OAC. SECTION VII. Specifications of Deliverables The contracted services shall include, but may not be limited to, the following areas:

1. Review and analyze Medicaid recipient’s case file documents and compare the determined injuries of the recipient to those injuries of typical tort damages associated with them to known judgements and settlements, where available, within the State of Ohio;

http://das.ohio.gov/Divisions/EqualOpportunity/AffirmativeActionEqualEmploymentOpportunity.aspx

http://das.ohio.gov/Divisions/EqualOpportunity/AffirmativeActionEqualEmploymentOpportunity.aspx


2. Establish a value that a reasonable judge or jury would award under all circumstances involved in the case, including, but not limited to: 1) defenses that might be offered by the defendant(s); 2) statutory damage capitations; and 3) other claims that may be included within an award;

3. Adhere to, and take into account, the prescribed standards and formula described in ORC § 5160.37(G),

as well as all applicable state and federal case law;

4. Render an opinion of the value of the case, and the reasons therefore, in a written detailed report to ODM within a timeframe negotiated between ODM and Contractor, but not longer than thirty (30) calendar days from date of hearing, that provides an aggregate monetary value for all of the tort claims associated with a third party liability case;

5. Ensure the report references, when appropriate, previous court awards with similar injuries in the State of Ohio, and documents the principles and methods used in the development of its findings;

6. Be prepared to respond to questions asked by ODM about the report;

7. Participate in relevant preparation for testimony in the third party liability hearing;

8. Respond to questions associated with appeals that resulted from these hearings (such questions would be

limited to the original report and testimony for the case; and

9. Appear and deliver live testimony consistent with the report when requested. SECTION VIII. Compensation The selected applicant will be compensated based upon the following flat fees for services rendered: Compensation paid per completed report - $500.00 Compensation paid per hearing appearance and testimony - $350.00 SECTION IX. Evaluation Process Applications will be collectively reviewed and evaluated by an Application Review Team (APT) appointed by ODM. The evaluation process will be based upon whether the applicant meets the requirements for Qualifications (Section V), Scope of Work (Section VI), and Specifications of Deliverables (Section VII). Additional criteria that may be evaluated exceeding the minimum qualifications within the scope of Section V, is quality of writing and appropriate conclusions of law as exhibited in the applicant’s writing sample, and an optional in-person interview, if requested by ODM. NOTE: The Veteran Friendly Procurement Program applies to all state agencies' purchases made by bid, proposal, or application under Chapter 125 of the ORC. Essentially, the Program allows for: Applications submitted by veteran-friendly suppliers to receive first consideration over applications submitted by businesses not certified as veteran-friendly of equal qualifications to be eligible for winning the award; and Statutory and Regulatory Award: The enabling statutes for the VBE program is ORC. 9.318. The regulations that govern the program are found in OAC Chapter 123:5-1-01 and 123:5-1-16.


SECTION X. Health Insurance Portability & Accessibility Act (HIPAA) Requirements As a condition of doing business with ODM, the Contractor, and any subcontractor(s), will be required to comply with 42 U.S.C. Sections 1320d through 1320d-8, and to implement regulations at 45 C.F.R. Section 164.502 (e) and Sections 164.504 (e) regarding disclosure of protected health information under the Health Insurance Portability and Accountability Act (HIPAA) of 1996. Protected Health Information (PHI) is information received by the Contractor from or on behalf of ODM that meets the definition of PHI as defined by HIPAA and the regulations promulgated by the United States Department of Health & Human Services (HHS), specifically 45 CFR 164.501 and any amendments thereto. SECTION XI. Protests Any potential, or actual, supplier objecting to the award of a contract resulting from the issuance of this RFA may file a protest of the award of the contract, or any other matter relating to the process of soliciting the proposals. Such a protest must comply with the following guidelines: A. A protest may be filed by a prospective or actual responder objecting to the award of a contract

resulting from this RFA. The protest shall be in writing and shall contain the following information:

1. The name, address, and telephone number of the protestor; 2. The name and number of the RFA being protested; 3. A detailed statement of the legal and factual grounds for the protest, including copies of

any relevant documents; 4. A request for a ruling by ODM; 5. A statement as to the form of relief requested from ODM; and 6. Any other information the protestor believes to be essential to the determination of the

factual and legal questions at issue in the written protest. B. A timely protest shall be considered by ODM, if it is received by ODM’s Contracts and

Procurement, within the following periods:

1. A protest based on alleged improprieties in the issuance of the RFA or any other event preceding the closing date for receipt of responses which are apparent or should be apparent prior to the closing date for receipt of responses shall be filed no later than 11:59 p.m. the closing date for receipt of responses, as specified in Section III, Anticipated Procurement Timetable, of this RFA.

2. If the protest relates to the announced intent to award a contract, the protest shall be filed

no later than 3:00 p.m. of seventh (7th) calendar day after the issuance of formal letters sent to all responding suppliers regarding the State’s intent to make the award. The date on these ODM letters to responding suppliers is the date used to determine if a protest regarding the intent to award is submitted by the end of the protest period.

C. An untimely protest may be considered by ODM if ODM determines that the protest raises issues

significant to the department’s procurement system. An untimely protest is one received by


ODM’s Office of Contracts and Procurement after the time periods set forth in Item B. of this Section.

D. All protests must be filed at the following location:

Deputy Legal Counsel Office of Contracts and Procurement Ohio Department of Medicaid 50 West Town Street Columbus, Ohio 43215

E. When a timely protest is filed, a contract award shall not proceed until a decision on the protest is

issued or the matter is otherwise resolved, unless the Director of ODM determines that a delay will severely disadvantage the Department. The supplier(s) who would have been awarded the contract shall be notified of the receipt of the protest.

F. ODM’s Office of Contracts and Procurement shall issue written decisions on all timely protests

and shall notify any supplier who filed an untimely protest as to whether or not the protest will be considered.

SECTION XII. State Contracts Applications must list any current contracts the supplier has with State of Ohio agencies and universities/colleges. The list must indicate the purpose of the contract, the amount of the contract, the time period covered by the contract, and the percent of the project completed. Suppliers must provide this information, and all other requested information listed in the “Required Supplier Information and Certifications” provided as Attachment A. Thank you for your interest in this project. Attachment A follows this page.

Attachment A1

REQUIRED VENDOR INFORMATION

Purpose: ODM requires the following information from vendors who submit proposals or bids in response to any ODM Requests for Proposals (RFPs) or Requests for Letterhead Bids (RLBs), in order to facilitate the development of the contract (or finalization of a purchase) with the selected vendor. ODM reserves the right

to reject your proposal if you fail to provide this information fully, accurately, and by the deadline set by ODM. Further, some of this information (as identified below) must be provided in order for ODM to accept and consider your proposal\bid. Failure to provide such required information may result in immediate

disqualification of your proposal.

Instructions: Provide the following information regarding the vendor submitting the proposal or bid. Vendors

may either print this attachment, complete and sign, or may provide the required information and certifications

(each fully re-stated from this attachment) on their letterhead as the opening pages of their proposals. It is

mandatory that the information provided is certified with an original signature (in blue ink, please) from a person

with authority to represent the vendor. Vendors are to provide the completed and signed information and

certifications as the cover pages of their original proposal submitted to ODM.

IMPORTANT: If the RFP\RLB specified a maximum page limit for vendor proposals\bids, the attachment

of any required certifications, other documents, or additional pages needed to fully provide the information

requested here will NOT be counted against that page limit.

Vendors must provide all information

1. ODM RFP/RLB# and TITLE: ____________________________________________________

2. Proposal Due Date: ___________________

3. Vendor Name: (legal name of vendor – person or organization – to whom contract/purchase payments will

be made:

4. Vendor Corporate Address:

5. Vendor Remittance Address: (or “same” if same as number 4. above)

6. Print or type the following information for the vendor’s representative/contact person authorized to

answer questions on the proposal/bid:

Vendor Representative Name and Title: ______________________________________________________

Vendor’s Representative Phone # and Email Address: __________________________________________

7. Is this vendor an Ohio certified MBE? Yes____ No____. If yes, attach a copy of current certification to

proposal/bid. If ODM has specified the RFP/RLB is an opportunity exclusively for MBEs, failure to attach a

copy of current certification may result in disqualification.

8. Vendor agrees to comply with the requirement to maintain a complete affirmative action plan and affirm they

will be in compliance with ORC § 125.111 prior to being awarded a contract.

Attachment A Page 1 of 4

Attachment A2 - Vendor and Grantee Ethics Certification

1. As a vendor or grantee doing business with* or receiving grants from the State of Ohio, I certify on behalf of (Name of vendor or grantee) that:

(1) I have reviewed and understand Ohio ethics and conflict of interest laws, as found in Chapter 102 and

Sections 2921.42 and 2921.43 of the Ohio Revised Code;

(2) I acknowledge that our organization is not excluded from entering into a contract with ODM due to

restrictions related to the federal debarment list, unresolved findings under ORC § 9.24 and unfair labor

findings pursuant to ORC § 121.23; and

(3) I acknowledge that failure to comply with this certification, is, by itself, grounds for termination of this contract or grant with the State of Ohio.

Signature of authorized agent Date

*”Doing business with” includes all contracts for goods and services, excluding purchases made using the

State of Ohio’s Payment Card Program that cost less than $1,000.

2. I have read the ODM Model Contract attached to the RFP/RLB, and if awarded a contract, I will not_______(or) I will______ request changes to the standard language, and have marked the requested changes and returned the model document with this proposal for consideration by ODM. (If changes are requested, ODM will review those changes if you are the selected vendor. All requested changes to model contract language are subject to ODM approval.)

NOTE: Item 3 below is not applicable and not required when the subject ODM procurement opportunity is offered only to State Term Schedule Vendors.)

3. I , (authorized vendor representative) hereby affirm that this proposal accurately represents the capabilities and qualifications of (vendor’s name), and I hereby affirm that the cost(s) bid to ODM for the performance of services and/or provision of goods covered in this proposal in response to the ODM RFP/RLB/other purchase opportunity is a firm fixed price, inclusive of all incidental as well as primary costs. (Failure to provide the proper affirming signature on this item may result in the disqualification of your proposal\bid.)

4. I _______________________________________, (authorized vendor representative) hereby attest

that I understand that any and all information included in this proposal is not confidential and/or trade

secret information (as defined in the RFP or where found in an RLB document) and that the proposal

submission may be posted in its entirety on the Internet for public viewing. Following submission to

ODM, all proposals submitted may become part of the public record. ODM reserves the right to disqualify

any vendor whose proposal is found to contain such prohibited personal information. The vendor

affirms that they shall be solely responsible for any and all information disclosed in the proposal submission

and any or all information released by ODM in a public records request(s).


Attachment A3 – Location of Business and Offshore Declaration Form

Location of Business Declaration: Vendors responding to any ODM RFP/RLB (etc.) must certify that no public funds shall

be spent on services provided/performed offshore by completing, signing, and returning the “Location of Business Form,”

which is the final section of this attachment. FAILURE TO PROPERLY COMPLETE, SIGN AND RETURN THIS

FORM MAY RESULT IN DISQUALIFICATION OF THE VENDOR FROM CONSIDERATION FOR AWARD

OF THIS ODM CONTRACT.

Pursuant to Governor’s Executive Order 2011-12K (www.governor.ohio.gov), no public funds shall be spent on services provided offshore. This form serves as a certification of compliance with this policy and required disclosures. Please

answer the following questions about the project or service you are seeking to perform for or the funding for which you are

applying from the Ohio Department of Medicaid:

1. Principal location of business of Contractor:

(Address) (City, State, Zip)

Name/Principal location of business of subcontractor(s):

(Name) (Address, City, State, Zip)


2. Location where services will be performed by Contractor:

(Address) (City, State, Zip)

Name/Location where services will be performed by subcontractor(s):



3. Location where state data will be stored, accessed, tested, maintained or backed-up, by Contractor:

(Address) (Address, City, State, Zip)

Name/Location(s) where state data will be stored, accessed, tested, maintained or backed-up by

subcontractor(s):





4. Location where services to be performed will be changed or shifted by Contractor:

(Address) (Address, City, State, Zip)

Name/Location(s) where services will be changed or shifted to be performed by subcontractor(s):




By signing below, I hereby certify and affirm that I have reviewed, understand, and will abide by the Governor’s Executive

Order 2011-12K. I attest that no funds provided by ODM for this project or any other agreement will be used to purchase

services provided outside the United States or to contract with a subcontractor who will use the funds to purchase services

provided outside the United States. I will promptly notify ODM if there is a change in the location where any of the services

relating to this project will be performed. If I am signing this on behalf of a company, business, or organization, I hereby

acknowledge that I have the authority to make this certification on behalf of that entity.

Signature Date

Entity Name Address (Principal place of business)

Printed name of individual authorized City, State, Zip

to sign on behalf of entity


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