Procurements
Due to the competitive procurement, we are in a statutorily imposed “Blackout Period” until 72 hours after the award and cannot provide interpretation or additional information not included in the LTC or MMA ITN documents.
As stated in s.287.057(23), F.S., “Respondents to this solicitation or persons acting on their behalf may not contact, between the release of the solicitation and the end of the 72-hour period following the agency posting the notice of intended award, excluding Saturdays, Sundays, and state holidays, any employee or officer of the executive or legislative branch concerning any aspect of this solicitation, except in writing to the procurement officer or as provided in the solicitation documents. Violation of this provision may be grounds for rejecting a response."
Any vendor seeking to submit a bid or proposal can access official Agency procurement advertisements at the Florida Department of Management Services, Vendor Bid System (VBS) website at the following link: http://www.myflorida.com/apps/vbs/vbs_www.main_menu. On the occasion when a procurement document has forms that the Agency is not able to load in PDF on the VBS, they will be posted here.
AHCA ITN 016-12/13
- Attachment F - Past Performance
- Attachment G - Required Certifications
- Attachment I - Drug-Free Workplace
- Attachment J - Cost Proposal
- Attachment J-1, Detailed Budget
- Attachment K - Cost Proposal for Annual Maintenance of System
- Attachment L - Required Statements
The above list of attachments are provided in secured Word documents. Any alteration and/or modification to the Agency approved forms will result in the Agency’s rejection of the vendor’s response.
As a reminder, parties interested in responding to AHCA ITN 016-12/13. must view the entire solicitation on the VBS website. To view the solicitation, search the Agency for Health Care Administration’s active competitive solicitations and select AHCA ITN 016-12/13.
AHCA ITN 017-12/13
- Exhibit C-1 Questions Template Instructions Region 1
- Exhibit C-2 Past Performance Client Reference Form Region 1
- Exhibit C-3 Required Certifications and Statements Region 1
- Exhibit C-4 Disclosure of Ownership and Control Interest Statement CMS 1513_Region 1
- Exhibit C-5 Managed Medical Assistance (MMA) Provider Service Network (PSN) Provider Ownership Interest Disclosure Report Region 1
- Exhibit C-6 List of Terminated Contracts Region 1
- Exhibit C-7 Vendor Certification Regarding Scrutinized Companies List Region 1
- Exhibit C-8 - Home Medical Equipment and Supplies Providers List Region 1
- Exhibit C-9 Regional Preference Hierarchy Region 1
- Exhibit C-10 Certification of Drug Free Workplace Program Region 1
- Exhibit E-1 Standard Submission Requirements and Evaluation Criteria Region 1
- Exhibit E-1-A SRC #5 Submission Requirements
- Exhibit E-1-B SRC #7 Submission Requirements
- Exhibit E-2 Standard Quality Measurement Tool Region 1
- Exhibit E-3-B_Provider Network Evaluation Tool_Region 1
- Exhibit E-4 Specialty Submission Requirements and Evaluation Criteria Region 1
- Exhibit E-5 Specialty Quality Measurement Tool Region 1
- Exhibit E-6 Respondent Attestation for Response Submission Region 1
- Exhibit F-2 Base Data Set_Non-LTC Population Region 1
- Exhibit F-3 Inflation Factors Region 1
- Exhibit F-5 SMMC LTC Population MMA Base Data Set Region 1
- Exhibit F-6
- Exhibit F-6_Attachment A-1 - Summary - Non-LTC MMA Data Book Member Months_Region 1
- Exhibit F-6_Attachment A-2a - Summary - Capitated Plan - FFS Data_Region 1
- Exhibit F-6_Attachment A-2b - Summary - Capitated Plan - Financial Data_Region 1
- Exhibit F-6_Attachment A-2c - Summary-Capitated Plan-MH Encounter Data_Region 1
- Exhibit F-6_Attachment A-2d - Summary - Capitated Plan - Hospital and Rx Encounter Data_Region 1
- Exhibit F-6_Attachment A-2e - Summary - Capitated Plan - Dental Encounter Data_Region 1
- Exhibit F-6_Attachment A-2f - Summary - Capitated Plan - Transportation Funding Data_Region 1
- Exhibit F-6_Attachment A-3a - Summary - Non-Capitated PSN - FFS Data_Region 1
- Exhibit F-6_Attachment A-3b - Summary - Non-Capitated PSN - MH Encounter Data_Region 1
- Exhibit F-6_Attachment A-3c - Summary - Non-Capitated PSN - Dental Encounter Data_Region 1
- Exhibit F-6_Attachment A-3d - Summary - Non-Capitated PSN -Transportation Funding Data_Region 1
- Exhibit F-6_Attachment A-4a - Summary - FFS System - FFS Data_Region 1
- Exhibit F-6_Attachment A-4b - Summary - FFS System - MH Encounter Data_Region 1
- Exhibit F-6_Attachment A-4c - Summary - FFS System - Dental Encounter Data_Region 1
- Exhibit F-6_Attachment A-4d - Summary - FFS System -Transportation Funding Data_Region 1
- Exhibit F-6_Attachment A-5a - Database - FFS Data_Region 1
- Exhibit F-6_Attachment A-5b - Database - Capitated Plan Financial Data_Region 1
- Exhibit F-6_Attachment A-5c - Database - Mental Health Encounter Data_Region 1
- Exhibit F-6_Attachment A-5d - Database - Hospital and Rx Encounter Data_Region 1
- Exhibit F-6_Attachment A-5e - Database - Dental Encounter Data_Region 1
- Exhibit F-6_Attachment A-5f - Database - Transportation Funding Data_Region 1
- Exhibit F-6_Attachment B.1 - SMMC MMA Data Summary_Region 1
- Exhibit F-6-D- Databook Service Mapping
- Exhibit F-9 Supplemental Information Region 1
- Exhibit F-10 Capitated Plan Cost Proposal Region 1
- Exhibit F-11 Non-Capitated Cost Proposal Region 1
The above list of attachments are provided in secured Word, Excel and PDF documents. Any alteration and/or modification to the Agency approved forms will result in the Agency’s rejection of the vendor’s response.
As a reminder, parties interested in responding to ITN 017-12/13 must view the entire solicitation on the VBS website. To view the solicitation, search the Agency for Health Care Administration’s active competitive solicitations and select AHCA ITN 017-12/13.
AHCA ITN 018-12/13
- Exhibit C-1 Questions Template Instructions Region 2
- Exhibit C-2 Past Performance Client Reference Form Region 2
- Exhibit C-3 Required Certifications and Statements Region 2
- Exhibit C-4 Disclosure of Ownership and Control Interest Statement CMS 1513_Region 2
- Exhibit C-5 Managed Medical Assistance (MMA) Provider Service Network (PSN) Provider Ownership Interest Disclosure Report Region 2
- Exhibit C-6 List of Terminated Contracts Region 2
- Exhibit C-7 Vendor Certification Regarding Scrutinized Companies List Region 2
- Exhibit C-8 - Home Medical Equipment and Supplies Providers List Region 2
- Exhibit C-9 Regional Preference Hierarchy Region 2
- Exhibit C-10 Certification of Drug Free Workplace Program Region 2
- Exhibit E-1 Standard Submission Requirements and Evaluation Criteria Region 2
- Exhibit E-1-A SRC #5 Submission Requirements
- Exhibit E-1-B SRC #7 Submission Requirements
- Exhibit E-2 Standard Quality Measurement Tool Region 2
- Exhibit E-3-B_Provider Network Evaluation Tool_Region 2
- Exhibit E-4 Specialty Submission Requirements and Evaluation Criteria Region 2
- Exhibit E-5 Specialty Quality Measurement Tool Region 2
- Exhibit E-6 Respondent Attestation for Response Submission Region 2
- Exhibit F-2 Base Data Set_Non-LTC Population Region 2
- Exhibit F-3 Inflation Factors Region 2
- Exhibit F-5 SMMC LTC Population MMA Base Data Set Region 2
- Exhibit F-6
- Exhibit F-6_Attachment A-1 - Summary - Non-LTC MMA Data Book Member Months_Region 2
- Exhibit F-6_Attachment A-2a - Summary - Capitated Plan - FFS Data_Region 2
- Exhibit F-6_Attachment A-2b - Summary - Capitated Plan - Financial Data_Region 2
- Exhibit F-6_Attachment A-2c - Summary-Capitated Plan-MH Encounter Data_Region 2
- Exhibit F-6_Attachment A-2d - Summary - Capitated Plan - Hospital and Rx Encounter Data_Region 2
- Exhibit F-6_Attachment A-2e - Summary - Capitated Plan - Dental Encounter Data_Region 2
- Exhibit F-6_Attachment A-2f - Summary - Capitated Plan - Transportation Funding Data_Region 2
- Exhibit F-6_Attachment A-3a - Summary - Non-Capitated PSN - FFS Data_Region 2
- Exhibit F-6_Attachment A-3b - Summary - Non-Capitated PSN - MH Encounter Data_Region 2
- Exhibit F-6_Attachment A-3c - Summary - Non-Capitated PSN - Dental Encounter Data_Region 2
- Exhibit F-6_Attachment A-3d - Summary - Non-Capitated PSN -Transportation Funding Data_Region 2
- Exhibit F-6_Attachment A-4a - Summary - FFS System - FFS Data_Region 2
- Exhibit F-6_Attachment A-4b - Summary - FFS System - MH Encounter Data_Region 2
- Exhibit F-6_Attachment A-4c - Summary - FFS System - Dental Encounter Data_Region 2
- Exhibit F-6_Attachment A-4d - Summary - FFS System -Transportation Funding Data_Region 2
- Exhibit F-6_Attachment A-5a - Database - FFS Data_Region 2
- Exhibit F-6_Attachment A-5b - Database - Capitated Plan Financial Data_Region 2
- Exhibit F-6_Attachment A-5c - Database - Mental Health Encounter Data_Region 2
- Exhibit F-6_Attachment A-5d - Database - Hospital and Rx Encounter Data_Region 2
- Exhibit F-6_Attachment A-5e - Database - Dental Encounter Data_Region 2
- Exhibit F-6_Attachment A-5f - Database - Transportation Funding Data_Region 2
- Exhibit F-6_Attachment B.1 - SMMC MMA Data Summary_Region 2
- Exhibit F-6-D- Databook Service Mapping
- Exhibit F-9 Supplemental Information Region 2
- Exhibit F-10 Capitated Plan Cost Proposal Region 2
- Exhibit F-11 Non-Capitated Cost Proposal Region 2
The above list of attachments are provided in secured Word, Excel and PDF documents. Any alteration and/or modification to the Agency approved forms will result in the Agency’s rejection of the vendor’s response.
As a reminder, parties interested in responding to AHCA ITN 018-12/13. must view the entire solicitation on the VBS website. To view the solicitation, search the Agency for Health Care Administration’s active competitive solicitations and select AHCA ITN 018-12/13.
AHCA ITN 019-12/13
- Exhibit C-1 Questions Template Instructions Region 3
- Exhibit C-2 Past Performance Client Reference Form Region 3
- Exhibit C-3 Required Certifications and Statements Region 3
- Exhibit C-4 Disclosure of Ownership and Control Interest Statement CMS 1513_Region 3
- Exhibit C-5 Managed Medical Assistance (MMA) Provider Service Network (PSN) Provider Ownership Interest Disclosure Report Region 3
- Exhibit C-6 List of Terminated Contracts Region 3
- Exhibit C-7 Vendor Certification Regarding Scrutinized Companies List Region 3
- Exhibit C-8 - Home Medical Equipment and Supplies Providers List Region 3
- Exhibit C-9 Certification of Drug Free Workplace Program Region 3
- Exhibit E-1 Standard Submission Requirements and Evaluation Criteria Region 3
- Exhibit E-1-A SRC #5 Submission Requirements
- Exhibit E-1-B SRC #7 Submission Requirements
- Exhibit E-2 Standard Quality Measurement Tool Region 3
- Exhibit E-3-B_Provider Network Evaluation Tool_Region 3
- Exhibit E-4 Specialty Submission Requirements and Evaluation Criteria Region 3
- Exhibit E-5 Specialty Quality Measurement Tool Region 3
- Exhibit E-6 Respondent Attestation for Response Submission Region 3
- Exhibit F-2 Base Data Set_Non-LTC Population Region 3
- Exhibit F-3 Inflation Factors Region 3
- Exhibit F-5 SMMC LTC Population MMA Base Data Set Region 3
- Exhibit F-6
- Exhibit F-6_Attachment A-1 - Summary - Non-LTC MMA Data Book Member Months_Region 3
- Exhibit F-6_Attachment A-2a - Summary - Capitated Plan - FFS Data_Region 3
- Exhibit F-6_Attachment A-2b - Summary - Capitated Plan - Financial Data_Region 3
- Exhibit F-6_Attachment A-2c - Summary-Capitated Plan-MH Encounter Data_Region 3
- Exhibit F-6_Attachment A-2d - Summary - Capitated Plan - Hospital and Rx Encounter Data_Region 3
- Exhibit F-6_Attachment A-2e - Summary - Capitated Plan - Dental Encounter Data_Region 3
- Exhibit F-6_Attachment A-2f - Summary - Capitated Plan - Transportation Funding Data_Region 3
- Exhibit F-6_Attachment A-3a - Summary - Non-Capitated PSN - FFS Data_Region 3
- Exhibit F-6_Attachment A-3b - Summary - Non-Capitated PSN - MH Encounter Data_Region 3
- Exhibit F-6_Attachment A-3c - Summary - Non-Capitated PSN - Dental Encounter Data_Region 3
- Exhibit F-6_Attachment A-3d - Summary - Non-Capitated PSN -Transportation Funding Data_Region 3
- Exhibit F-6_Attachment A-4a - Summary - FFS System - FFS Data_Region 3
- Exhibit F-6_Attachment A-4b - Summary - FFS System - MH Encounter Data_Region 3
- Exhibit F-6_Attachment A-4c - Summary - FFS System - Dental Encounter Data_Region 3
- Exhibit F-6_Attachment A-4d - Summary - FFS System -Transportation Funding Data_Region 3
- Exhibit F-6_Attachment A-5a - Database - FFS Data_Region 3
- Exhibit F-6_Attachment A-5b - Database - Capitated Plan Financial Data_Region 3
- Exhibit F-6_Attachment A-5c - Database - Mental Health Encounter Data_Region 3
- Exhibit F-6_Attachment A-5d - Database - Hospital and Rx Encounter Data_Region 3
- Exhibit F-6_Attachment A-5e - Database - Dental Encounter Data_Region 3
- Exhibit F-6_Attachment A-5f - Database - Transportation Funding Data_Region 3
- Exhibit F-6_Attachment B.1 - SMMC MMA Data Summary_Region 3
- Exhibit F-6-D- Databook Service Mapping
- Exhibit F-9 Supplemental Information Region 3
- Exhibit F-10 Capitated Plan Cost Proposal Region 3
- Exhibit F-11 Non-Capitated Cost Proposal Region 3
The above list of attachments are provided in secured Word, Excel and PDF documents. Any alteration and/or modification to the Agency approved forms will result in the Agency’s rejection of the vendor’s response.
As a reminder, parties interested in responding to AHCA ITN 019-12/13. must view the entire solicitation on the VBS website. To view the solicitation, search the Agency for Health Care Administration’s active competitive solicitations and select AHCA ITN 019-12/13.
AHCA ITN 020-12/13
- Exhibit C-1 Questions Template Instructions Region 4
- Exhibit C-2 Past Performance Client Reference Form Region 4
- Exhibit C-3 Required Certifications and Statements Region 4
- Exhibit C-4 Disclosure of Ownership and Control Interest Statement CMS 1513_Region 4
- Exhibit C-5 Managed Medical Assistance (MMA) Provider Service Network (PSN) Provider Ownership Interest Disclosure Report Region 4
- Exhibit C-6 List of Terminated Contracts Region 4
- Exhibit C-7 Vendor Certification Regarding Scrutinized Companies List Region 4
- Exhibit C-8 - Home Medical Equipment and Supplies Providers List Region 4
- Exhibit C-9 Certification of Drug Free Workplace Program Region 4
- Exhibit E-1 Standard Submission Requirements and Evaluation Criteria Region 4
- Exhibit E-1-A SRC #5 Submission Requirements
- Exhibit E-1-B SRC #7 Submission Requirements
- Exhibit E-2 Standard Quality Measurement Tool Region 4
- Exhibit E-3-B_Provider Network Evaluation Tool_Region 4
- Exhibit E-4 Specialty Submission Requirements and Evaluation Criteria Region 4
- Exhibit E-5 Specialty Quality Measurement Tool Region 4
- Exhibit E-6 Respondent Attestation for Response Submission Region 4
- Exhibit F-2 Base Data Set_Non-LTC Population Region 4
- Exhibit F-3 Inflation Factors Region 4
- Exhibit F-5 SMMC LTC Population MMA Base Data Set Region 4
- Exhibit F-6
- Exhibit F-6_Attachment A-1 - Summary - Non-LTC MMA Data Book Member Months_Region 4
- Exhibit F-6_Attachment A-2a - Summary - Capitated Plan - FFS Data_Region 4
- Exhibit F-6_Attachment A-2b - Summary - Capitated Plan - Financial Data_Region 4
- Exhibit F-6_Attachment A-2c - Summary-Capitated Plan-MH Encounter Data_Region 4
- Exhibit F-6_Attachment A-2d - Summary - Capitated Plan - Hospital and Rx Encounter Data_Region 4
- Exhibit F-6_Attachment A-2e - Summary - Capitated Plan - Dental Encounter Data_Region 4
- Exhibit F-6_Attachment A-2f - Summary - Capitated Plan - Transportation Funding Data_Region 4
- Exhibit F-6_Attachment A-3a - Summary - Non-Capitated PSN - FFS Data_Region 4
- Exhibit F-6_Attachment A-3b - Summary - Non-Capitated PSN - MH Encounter Data_Region 4
- Exhibit F-6_Attachment A-3c - Summary - Non-Capitated PSN - Dental Encounter Data_Region 4
- Exhibit F-6_Attachment A-3d - Summary - Non-Capitated PSN -Transportation Funding Data_Region 4
- Exhibit F-6_Attachment A-4a - Summary - FFS System - FFS Data_Region 4
- Exhibit F-6_Attachment A-4b - Summary - FFS System - MH Encounter Data_Region 4
- Exhibit F-6_Attachment A-4c - Summary - FFS System - Dental Encounter Data_Region 4
- Exhibit F-6_Attachment A-4d - Summary - FFS System -Transportation Funding Data_Region 4
- Exhibit F-6_Attachment A-5a - Database - FFS Data_Region 4
- Exhibit F-6_Attachment A-5b - Database - Capitated Plan Financial Data_Region 4
- Exhibit F-6_Attachment A-5c - Database - Mental Health Encounter Data_Region 4
- Exhibit F-6_Attachment A-5d - Database - Hospital and Rx Encounter Data_Region 4
- Exhibit F-6_Attachment A-5e - Database - Dental Encounter Data_Region 4
- Exhibit F-6_Attachment A-5f - Database - Transportation Funding Data_Region 4
- Exhibit F-6_Attachment B.1 - SMMC MMA Data Summary_Region 4
- Exhibit F-6-D- Databook Service Mapping
- Exhibit F-9 Supplemental Information Region 4
- Exhibit F-10 Capitated Plan Cost Proposal Region 4
- Exhibit F-11 Non-Capitated Cost Proposal Region 4
The above list of attachments are provided in secured Word, Excel and PDF documents. Any alteration and/or modification to the Agency approved forms will result in the Agency’s rejection of the vendor’s response.
As a reminder, parties interested in responding to AHCA ITN 020-12/13. must view the entire solicitation on the VBS website. To view the solicitation, search the Agency for Health Care Administration’s active competitive solicitations and select AHCA ITN 020-12/13.
AHCA ITN 021-12/13
- Exhibit C-1 Questions Template Instructions Region 5
- Exhibit C-2 Past Performance Client Reference Form Region 5
- Exhibit C-3 Required Certifications and Statements Region 5
- Exhibit C-4 Disclosure of Ownership and Control Interest Statement CMS 1513_Region 5
- Exhibit C-5 Managed Medical Assistance (MMA) Provider Service Network (PSN) Provider Ownership Interest Disclosure Report Region 5
- Exhibit C-6 List of Terminated Contracts Region 5
- Exhibit C-7 Vendor Certification Regarding Scrutinized Companies List Region 5
- Exhibit C-8 - Home Medical Equipment and Supplies Providers List Region 5
- Exhibit C-9 Certification of Drug Free Workplace Program Region 5
- Exhibit E-1 Standard Submission Requirements and Evaluation Criteria Region 5
- Exhibit E-1-A SRC #5 Submission Requirements
- Exhibit E-1-B SRC #7 Submission Requirements
- Exhibit E-2 Standard Quality Measurement Tool Region 5
- Exhibit E-3-B_Provider Network Evaluation Tool_Region 5
- Exhibit E-4 Specialty Submission Requirements and Evaluation Criteria Region 5
- Exhibit E-5 Specialty Quality Measurement Tool Region 5
- Exhibit E-6 Respondent Attestation for Response Submission Region 5
- Exhibit F-2 Base Data Set_Non-LTC Population Region 5
- Exhibit F-3 Inflation Factors Region 5
- Exhibit F-5 SMMC LTC Population MMA Base Data Set Region 5
- Exhibit F-6
- Exhibit F-6_Attachment A-1 - Summary - Non-LTC MMA Data Book Member Months_Region 5
- Exhibit F-6_Attachment A-2a - Summary - Capitated Plan - FFS Data_Region 5
- Exhibit F-6_Attachment A-2b - Summary - Capitated Plan - Financial Data_Region 5
- Exhibit F-6_Attachment A-2c - Summary-Capitated Plan-MH Encounter Data_Region 5
- Exhibit F-6_Attachment A-2d - Summary - Capitated Plan - Hospital and Rx Encounter Data_Region 5
- Exhibit F-6_Attachment A-2e - Summary - Capitated Plan - Dental Encounter Data_Region 5
- Exhibit F-6_Attachment A-2f - Summary - Capitated Plan - Transportation Funding Data_Region 5
- Exhibit F-6_Attachment A-3a - Summary - Non-Capitated PSN - FFS Data_Region 5
- Exhibit F-6_Attachment A-3b - Summary - Non-Capitated PSN - MH Encounter Data_Region 5
- Exhibit F-6_Attachment A-3c - Summary - Non-Capitated PSN - Dental Encounter Data_Region 5
- Exhibit F-6_Attachment A-3d - Summary - Non-Capitated PSN -Transportation Funding Data_Region 5
- Exhibit F-6_Attachment A-4a - Summary - FFS System - FFS Data_Region 5
- Exhibit F-6_Attachment A-4b - Summary - FFS System - MH Encounter Data_Region 5
- Exhibit F-6_Attachment A-4c - Summary - FFS System - Dental Encounter Data_Region 5
- Exhibit F-6_Attachment A-4d - Summary - FFS System -Transportation Funding Data_Region 5
- Exhibit F-6_Attachment A-5a - Database - FFS Data_Region 5
- Exhibit F-6_Attachment A-5b - Database - Capitated Plan Financial Data_Region 5
- Exhibit F-6_Attachment A-5c - Database - Mental Health Encounter Data_Region 5
- Exhibit F-6_Attachment A-5d - Database - Hospital and Rx Encounter Data_Region 5
- Exhibit F-6_Attachment A-5e - Database - Dental Encounter Data_Region 5
- Exhibit F-6_Attachment A-5f - Database - Transportation Funding Data_Region 5
- Exhibit F-6_Attachment B.1 - SMMC MMA Data Summary_Region 5
- Exhibit F-6-D- Databook Service Mapping
- Exhibit F-9 Supplemental Information Region 5
- Exhibit F-10 Capitated Plan Cost Proposal Region 5
- Exhibit F-11 Non-Capitated Cost Proposal Region 5
The above list of attachments are provided in secured Word, Excel and PDF documents. Any alteration and/or modification to the Agency approved forms will result in the Agency’s rejection of the vendor’s response.
As a reminder, parties interested in responding to AHCA ITN 021-12/13. must view the entire solicitation on the VBS website. To view the solicitation, search the Agency for Health Care Administration’s active competitive solicitations and select AHCA ITN 021-12/13.
AHCA ITN 022-12/13
- Exhibit C-1 Questions Template Instructions Region 6
- Exhibit C-2 Past Performance Client Reference Form Region 6
- Exhibit C-3 Required Certifications and Statements Region 6
- Exhibit C-4 Disclosure of Ownership and Control Interest Statement CMS 1513_Region 6
- Exhibit C-5 Managed Medical Assistance (MMA) Provider Service Network (PSN) Provider Ownership Interest Disclosure Report Region 6
- Exhibit C-6 List of Terminated Contracts Region 6
- Exhibit C-7 Vendor Certification Regarding Scrutinized Companies List Region 6
- Exhibit C-8 - Home Medical Equipment and Supplies Providers List Region 6
- Exhibit C-9 Certification of Drug Free Workplace Program Region 6
- Exhibit E-1 Standard Submission Requirements and Evaluation Criteria Region 6
- Exhibit E-1-A SRC #5 Submission Requirements
- Exhibit E-1-B SRC #7 Submission Requirements
- Exhibit E-2 Standard Quality Measurement Tool Region 6
- Exhibit E-3-B_Provider Network Evaluation Tool_Region 6
- Exhibit E-4 Specialty Submission Requirements and Evaluation Criteria Region 6
- Exhibit E-5 Specialty Quality Measurement Tool Region 6
- Exhibit E-6 Respondent Attestation for Response Submission Region 6
- Exhibit F-2 Base Data Set_Non-LTC Population Region 6
- Exhibit F-3 Inflation Factors Region 6
- Exhibit F-5 SMMC LTC Population MMA Base Data Set Region 6
- Exhibit F-6
- Exhibit F-6_Attachment A-1 - Summary - Non-LTC MMA Data Book Member Months_Region 6
- Exhibit F-6_Attachment A-2a - Summary - Capitated Plan - FFS Data_Region 6
- Exhibit F-6_Attachment A-2b - Summary - Capitated Plan - Financial Data_Region 6
- Exhibit F-6_Attachment A-2c - Summary-Capitated Plan-MH Encounter Data_Region 6
- Exhibit F-6_Attachment A-2d - Summary - Capitated Plan - Hospital and Rx Encounter Data_Region 6
- Exhibit F-6_Attachment A-2e - Summary - Capitated Plan - Dental Encounter Data_Region 6
- Exhibit F-6_Attachment A-2f - Summary - Capitated Plan - Transportation Funding Data_Region 6
- Exhibit F-6_Attachment A-3a - Summary - Non-Capitated PSN - FFS Data_Region 6
- Exhibit F-6_Attachment A-3b - Summary - Non-Capitated PSN - MH Encounter Data_Region 6
- Exhibit F-6_Attachment A-3c - Summary - Non-Capitated PSN - Dental Encounter Data_Region 6
- Exhibit F-6_Attachment A-3d - Summary - Non-Capitated PSN -Transportation Funding Data_Region 5
- Exhibit F-6_Attachment A-4a - Summary - FFS System - FFS Data_Region 6
- Exhibit F-6_Attachment A-4b - Summary - FFS System - MH Encounter Data_Region 6
- Exhibit F-6_Attachment A-4c - Summary - FFS System - Dental Encounter Data_Region 6
- Exhibit F-6_Attachment A-4d - Summary - FFS System -Transportation Funding Data_Region 6
- Exhibit F-6_Attachment A-5a - Database - FFS Data_Region 6
- Exhibit F-6_Attachment A-5b - Database - Capitated Plan Financial Data_Region 6
- Exhibit F-6_Attachment A-5c - Database - Mental Health Encounter Data_Region 6
- Exhibit F-6_Attachment A-5d - Database - Hospital and Rx Encounter Data_Region 6
- Exhibit F-6_Attachment A-5e - Database - Dental Encounter Data_Region 6
- Exhibit F-6_Attachment A-5f - Database - Transportation Funding Data_Region 6
- Exhibit F-6_Attachment B.1 - SMMC MMA Data Summary_Region 6
- Exhibit F-6-D- Databook Service Mapping
- Exhibit F-9 Supplemental Information Region 6
- Exhibit F-10 Capitated Plan Cost Proposal Region 6
- Exhibit F-11 Non-Capitated Cost Proposal Region 6
The above list of attachments are provided in secured Word, Excel and PDF documents. Any alteration and/or modification to the Agency approved forms will result in the Agency’s rejection of the vendor’s response.
As a reminder, parties interested in responding to AHCA ITN 022-12/13. must view the entire solicitation on the VBS website. To view the solicitation, search the Agency for Health Care Administration’s active competitive solicitations and select AHCA ITN 022-12/13.
AHCA ITN 023-12/13
- Exhibit C-1 Questions Template Instructions Region 7
- Exhibit C-2 Past Performance Client Reference Form Region 7
- Exhibit C-3 Required Certifications and Statements Region 7
- Exhibit C-4 Disclosure of Ownership and Control Interest Statement CMS 1513_Region 7
- Exhibit C-5 Managed Medical Assistance (MMA) Provider Service Network (PSN) Provider Ownership Interest Disclosure Report Region 7
- Exhibit C-6 List of Terminated Contracts Region 7
- Exhibit C-7 Vendor Certification Regarding Scrutinized Companies List Region 7
- Exhibit C-8 - Home Medical Equipment and Supplies Providers List Region 7
- Exhibit C-9 Certification of Drug Free Workplace Program Region 7
- Exhibit E-1 Standard Submission Requirements and Evaluation Criteria Region 7
- Exhibit E-1-A SRC #5 Submission Requirements
- Exhibit E-1-B SRC #7 Submission Requirements
- Exhibit E-2 Standard Quality Measurement Tool Region 7
- Exhibit E-3-B_Provider Network Evaluation Tool_Region 7
- Exhibit E-4 Specialty Submission Requirements and Evaluation Criteria Region 7
- Exhibit E-5 Specialty Quality Measurement Tool Region 7
- Exhibit E-6 Respondent Attestation for Response Submission Region 7
- Exhibit F-2 Base Data Set_Non-LTC Population Region 7
- Exhibit F-3 Inflation Factors Region 7
- Exhibit F-5 SMMC LTC Population MMA Base Data Set Region 7
- Exhibit F-6
- Exhibit F-6_Attachment A-1 - Summary - Non-LTC MMA Data Book Member Months_Region 7
- Exhibit F-6_Attachment A-2a - Summary - Capitated Plan - FFS Data_Region 7
- Exhibit F-6_Attachment A-2b - Summary - Capitated Plan - Financial Data_Region 7
- Exhibit F-6_Attachment A-2c - Summary-Capitated Plan-MH Encounter Data_Region 7
- Exhibit F-6_Attachment A-2d - Summary - Capitated Plan - Hospital and Rx Encounter Data_Region 7
- Exhibit F-6_Attachment A-2e - Summary - Capitated Plan - Dental Encounter Data_Region 7
- Exhibit F-6_Attachment A-2f - Summary - Capitated Plan - Transportation Funding Data_Region 7
- Exhibit F-6_Attachment A-3a - Summary - Non-Capitated PSN - FFS Data_Region 7
- Exhibit F-6_Attachment A-3b - Summary - Non-Capitated PSN - MH Encounter Data_Region 7
- Exhibit F-6_Attachment A-3c - Summary - Non-Capitated PSN - Dental Encounter Data_Region 7
- Exhibit F-6_Attachment A-3d - Summary - Non-Capitated PSN -Transportation Funding Data_Region 7
- Exhibit F-6_Attachment A-4a - Summary - FFS System - FFS Data_Region 7
- Exhibit F-6_Attachment A-4b - Summary - FFS System - MH Encounter Data_Region 7
- Exhibit F-6_Attachment A-4c - Summary - FFS System - Dental Encounter Data_Region 7
- Exhibit F-6_Attachment A-4d - Summary - FFS System -Transportation Funding Data_Region 7
- Exhibit F-6_Attachment A-5a - Database - FFS Data_Region 7
- Exhibit F-6_Attachment A-5b - Database - Capitated Plan Financial Data_Region 7
- Exhibit F-6_Attachment A-5c - Database - Mental Health Encounter Data_Region 7
- Exhibit F-6_Attachment A-5d - Database - Hospital and Rx Encounter Data_Region 7
- Exhibit F-6_Attachment A-5e - Database - Dental Encounter Data_Region 7
- Exhibit F-6_Attachment A-5f - Database - Transportation Funding Data_Region 7
- Exhibit F-6_Attachment B.1 - SMMC MMA Data Summary_Region 7
- Exhibit F-6-D- Databook Service Mapping
- Exhibit F-9 Supplemental Information Region 7
- Exhibit F-10 Capitated Plan Cost Proposal Region 7
- Exhibit F-11 Non-Capitated Cost Proposal Region 7
The above list of attachments are provided in secured Word, Excel and PDF documents. Any alteration and/or modification to the Agency approved forms will result in the Agency’s rejection of the vendor’s response.
As a reminder, parties interested in responding to AHCA ITN 023-12/13. must view the entire solicitation on the VBS website. To view the solicitation, search the Agency for Health Care Administration’s active competitive solicitations and select AHCA ITN 023-12/13.
AHCA ITN 024-12/13
- Exhibit C-1 Questions Template Instructions Region 8
- Exhibit C-2 Past Performance Client Reference Form Region 8
- Exhibit C-3 Required Certifications and Statements Region 8
- Exhibit C-4 Disclosure of Ownership and Control Interest Statement CMS 1513_Region 8
- Exhibit C-5 Managed Medical Assistance (MMA) Provider Service Network (PSN) Provider Ownership Interest Disclosure Report Region 8
- Exhibit C-6 List of Terminated Contracts Region 8
- Exhibit C-7 Vendor Certification Regarding Scrutinized Companies List Region 8
- Exhibit C-8 - Home Medical Equipment and Supplies Providers List Region 8
- Exhibit C-9 Certification of Drug Free Workplace Program Region 8
- Exhibit E-1 Standard Submission Requirements and Evaluation Criteria Region 8
- Exhibit E-1-A SRC #5 Submission Requirements
- Exhibit E-1-B SRC #7 Submission Requirements
- Exhibit E-2 Standard Quality Measurement Tool Region 8
- Exhibit E-3-B_Provider Network Evaluation Tool_Region 8
- Exhibit E-4 Specialty Submission Requirements and Evaluation Criteria Region 8
- Exhibit E-5 Specialty Quality Measurement Tool Region 8
- Exhibit E-6 Respondent Attestation for Response Submission Region 8
- Exhibit F-2 Base Data Set_Non-LTC Population Region 8
- Exhibit F-3 Inflation Factors Region 8
- Exhibit F-5 SMMC LTC Population MMA Base Data Set Region 8
- Exhibit F-6
- Exhibit F-6_Attachment A-1 - Summary - Non-LTC MMA Data Book Member Months_Region 8
- Exhibit F-6_Attachment A-2a - Summary - Capitated Plan - FFS Data_Region 8
- Exhibit F-6_Attachment A-2b - Summary - Capitated Plan - Financial Data_Region 8
- Exhibit F-6_Attachment A-2c - Summary-Capitated Plan-MH Encounter Data_Region 8
- Exhibit F-6_Attachment A-2d - Summary - Capitated Plan - Hospital and Rx Encounter Data_Region 8
- Exhibit F-6_Attachment A-2e - Summary - Capitated Plan - Dental Encounter Data_Region 8
- Exhibit F-6_Attachment A-2f - Summary - Capitated Plan - Transportation Funding Data_Region 8
- Exhibit F-6_Attachment A-3a - Summary - Non-Capitated PSN - FFS Data_Region 8
- Exhibit F-6_Attachment A-3b - Summary - Non-Capitated PSN - MH Encounter Data_Region 8
- Exhibit F-6_Attachment A-3c - Summary - Non-Capitated PSN - Dental Encounter Data_Region 8
- Exhibit F-6_Attachment A-3d - Summary - Non-Capitated PSN -Transportation Funding Data_Region 8
- Exhibit F-6_Attachment A-4a - Summary - FFS System - FFS Data_Region 8
- Exhibit F-6_Attachment A-4b - Summary - FFS System - MH Encounter Data_Region 8
- Exhibit F-6_Attachment A-4c - Summary - FFS System - Dental Encounter Data_Region 8
- Exhibit F-6_Attachment A-4d - Summary - FFS System -Transportation Funding Data_Region 8
- Exhibit F-6_Attachment A-5a - Database - FFS Data_Region 8
- Exhibit F-6_Attachment A-5b - Database - Capitated Plan Financial Data_Region 8
- Exhibit F-6_Attachment A-5c - Database - Mental Health Encounter Data_Region 8
- Exhibit F-6_Attachment A-5d - Database - Hospital and Rx Encounter Data_Region 8
- Exhibit F-6_Attachment A-5e - Database - Dental Encounter Data_Region 8
- Exhibit F-6_Attachment A-5f - Database - Transportation Funding Data_Region 8
- Exhibit F-6_Attachment B.1 - SMMC MMA Data Summary_Region 8
- Exhibit F-6-D- Databook Service Mapping
- Exhibit F-9 Supplemental Information Region 8
- Exhibit F-10 Capitated Plan Cost Proposal Region 8
- Exhibit F-11 Non-Capitated Cost Proposal Region 8
The above list of attachments are provided in secured Word, Excel and PDF documents. Any alteration and/or modification to the Agency approved forms will result in the Agency’s rejection of the vendor’s response.
As a reminder, parties interested in responding to AHCA ITN 024-12/13. must view the entire solicitation on the VBS website. To view the solicitation, search the Agency for Health Care Administration’s active competitive solicitations and select AHCA ITN 024-12/13.
AHCA ITN 025-12/13
- Exhibit C-1 Questions Template Instructions Region 9
- Exhibit C-2 Past Performance Client Reference Form Region 9
- Exhibit C-3 Required Certifications and Statements Region 9
- Exhibit C-4 Disclosure of Ownership and Control Interest Statement CMS 1513_Region 9
- Exhibit C-5 Managed Medical Assistance (MMA) Provider Service Network (PSN) Provider Ownership Interest Disclosure Report Region 9
- Exhibit C-6 List of Terminated Contracts Region 9
- Exhibit C-7 Vendor Certification Regarding Scrutinized Companies List Region 9
- Exhibit C-8 - Home Medical Equipment and Supplies Providers List Region 9
- Exhibit C-9 Certification of Drug Free Workplace Program Region 9
- Exhibit E-1 Standard Submission Requirements and Evaluation Criteria Region 9
- Exhibit E-1-A SRC #5 Submission Requirements
- Exhibit E-1-B SRC #7 Submission Requirements
- Exhibit E-2 Standard Quality Measurement Tool Region 9
- Exhibit E-3-B_Provider Network Evaluation Tool_Region 9
- Exhibit E-4 Specialty Submission Requirements and Evaluation Criteria Region 9
- Exhibit E-5 Specialty Quality Measurement Tool Region 9
- Exhibit E-6 Respondent Attestation for Response Submission Region 9
- Exhibit F-2 Base Data Set_Non-LTC Population Region 9
- Exhibit F-3 Inflation Factors Region 9
- Exhibit F-5 SMMC LTC Population MMA Base Data Set Region 9
- Exhibit F-6
- Exhibit F-6_Attachment A-1 - Summary - Non-LTC MMA Data Book Member Months_Region 9
- Exhibit F-6_Attachment A-2a - Summary - Capitated Plan - FFS Data_Region 9
- Exhibit F-6_Attachment A-2b - Summary - Capitated Plan - Financial Data_Region 9
- Exhibit F-6_Attachment A-2c - Summary-Capitated Plan-MH Encounter Data_Region 9
- Exhibit F-6_Attachment A-2d - Summary - Capitated Plan - Hospital and Rx Encounter Data_Region 9
- Exhibit F-6_Attachment A-2e - Summary - Capitated Plan - Dental Encounter Data_Region 9
- Exhibit F-6_Attachment A-2f - Summary - Capitated Plan - Transportation Funding Data_Region 9
- Exhibit F-6_Attachment A-3a - Summary - Non-Capitated PSN - FFS Data_Region 9
- Exhibit F-6_Attachment A-3b - Summary - Non-Capitated PSN - MH Encounter Data_Region 9
- Exhibit F-6_Attachment A-3c - Summary - Non-Capitated PSN - Dental Encounter Data_Region 9
- Exhibit F-6_Attachment A-3d - Summary - Non-Capitated PSN -Transportation Funding Data_Region 9
- Exhibit F-6_Attachment A-4a - Summary - FFS System - FFS Data_Region 9
- Exhibit F-6_Attachment A-4b - Summary - FFS System - MH Encounter Data_Region 9
- Exhibit F-6_Attachment A-4c - Summary - FFS System - Dental Encounter Data_Region 9
- Exhibit F-6_Attachment A-4d - Summary - FFS System -Transportation Funding Data_Region 9
- Exhibit F-6_Attachment A-5a - Database - FFS Data_Region 9
- Exhibit F-6_Attachment A-5b - Database - Capitated Plan Financial Data_Region 9
- Exhibit F-6_Attachment A-5c - Database - Mental Health Encounter Data_Region 9
- Exhibit F-6_Attachment A-5d - Database - Hospital and Rx Encounter Data_Region 9
- Exhibit F-6_Attachment A-5e - Database - Dental Encounter Data_Region 9
- Exhibit F-6_Attachment A-5f - Database - Transportation Funding Data_Region 9
- Exhibit F-6_Attachment B.1 - SMMC MMA Data Summary_Region 8
- Exhibit F-6-D- Databook Service Mapping
- Exhibit F-9 Supplemental Information Region 9
- Exhibit F-10 Capitated Plan Cost Proposal Region 9
- Exhibit F-11 Non-Capitated Cost Proposal Region 9
The above list of attachments are provided in secured Word, Excel and PDF documents. Any alteration and/or modification to the Agency approved forms will result in the Agency’s rejection of the vendor’s response.
As a reminder, parties interested in responding to AHCA ITN 025-12/13. must view the entire solicitation on the VBS website. To view the solicitation, search the Agency for Health Care Administration’s active competitive solicitations and select AHCA ITN 025-12/13.
AHCA ITN 026-12/13
- Exhibit C-1 Questions Template Instructions Region 10
- Exhibit C-2 Past Performance Client Reference Form Region 10
- Exhibit C-3 Required Certifications and Statements Region 10
- Exhibit C-4 Disclosure of Ownership and Control Interest Statement CMS 1513_Region 10
- Exhibit C-5 Managed Medical Assistance (MMA) Provider Service Network (PSN) Provider Ownership Interest Disclosure Report Region 10
- Exhibit C-6 List of Terminated Contracts Region 10
- Exhibit C-7 Vendor Certification Regarding Scrutinized Companies List Region 10
- Exhibit C-8 - Home Medical Equipment and Supplies Providers List Region 10
- Exhibit C-9 Certification of Drug Free Workplace Program Region 10
- Exhibit E-1 Standard Submission Requirements and Evaluation Criteria Region 10
- Exhibit E-1-A SRC #5 Submission Requirements
- Exhibit E-1-B SRC #7 Submission Requirements
- Exhibit E-2 Standard Quality Measurement Tool Region 10
- Exhibit E-3-B_Provider Network Evaluation Tool_Region 10
- Exhibit E-4 Specialty Submission Requirements and Evaluation Criteria Region 10
- Exhibit E-5 Specialty Quality Measurement Tool Region 10
- Exhibit E-6 Respondent Attestation for Response Submission Region 10
- Exhibit F-2 Base Data Set_Non-LTC Population Region 10
- Exhibit F-3 Inflation Factors Region 10
- Exhibit F-5 SMMC LTC Population MMA Base Data Set Region 10
- Exhibit F-6
- Exhibit F-6_Attachment A-1 - Summary - Non-LTC MMA Data Book Member Months_Region 10
- Exhibit F-6_Attachment A-2a - Summary - Capitated Plan - FFS Data_Region 10
- Exhibit F-6_Attachment A-2b - Summary - Capitated Plan - Financial Data_Region 10
- Exhibit F-6_Attachment A-2c - Summary-Capitated Plan-MH Encounter Data_Region 10
- Exhibit F-6_Attachment A-2d - Summary - Capitated Plan - Hospital and Rx Encounter Data_Region 10
- Exhibit F-6_Attachment A-2e - Summary - Capitated Plan - Dental Encounter Data_Region 10
- Exhibit F-6_Attachment A-2f - Summary - Capitated Plan - Transportation Funding Data_Region 10
- Exhibit F-6_Attachment A-3a - Summary - Non-Capitated PSN - FFS Data_Region 10
- Exhibit F-6_Attachment A-3b - Summary - Non-Capitated PSN - MH Encounter Data_Region 10
- Exhibit F-6_Attachment A-3c - Summary - Non-Capitated PSN - Dental Encounter Data_Region 10
- Exhibit F-6_Attachment A-3d - Summary - Non-Capitated PSN -Transportation Funding Data_Region 10
- Exhibit F-6_Attachment A-4a - Summary - FFS System - FFS Data_Region 10
- Exhibit F-6_Attachment A-4b - Summary - FFS System - MH Encounter Data_Region 10
- Exhibit F-6_Attachment A-4c - Summary - FFS System - Dental Encounter Data_Region 10
- Exhibit F-6_Attachment A-4d - Summary - FFS System -Transportation Funding Data_Region 10
- Exhibit F-6_Attachment A-5a - Database - FFS Data_Region 10
- Exhibit F-6_Attachment A-5b - Database - Capitated Plan Financial Data_Region 10
- Exhibit F-6_Attachment A-5c - Database - Mental Health Encounter Data_Region 10
- Exhibit F-6_Attachment A-5d - Database - Hospital and Rx Encounter Data_Region 10
- Exhibit F-6_Attachment A-5e - Database - Dental Encounter Data_Region 10
- Exhibit F-6_Attachment A-5f - Database - Transportation Funding Data_Region 10
- Exhibit F-6_Attachment B.1 - SMMC MMA Data Summary_Region 10
- Exhibit F-6-D- Databook Service Mapping
- Exhibit F-9 Supplemental Information Region 10
- Exhibit F-10 Capitated Plan Cost Proposal Region 10
- Exhibit F-11 Non-Capitated Cost Proposal Region 10
The above list of attachments are provided in secured Word, Excel and PDF documents. Any alteration and/or modification to the Agency approved forms will result in the Agency’s rejection of the vendor’s response.
As a reminder, parties interested in responding to AHCA ITN 026-12/13. must view the entire solicitation on the VBS website. To view the solicitation, search the Agency for Health Care Administration’s active competitive solicitations and select AHCA ITN 026-12/13.
AHCA ITN 027-12/13
- Exhibit C-1 Questions Template Instructions Region 11
- Exhibit C-2 Past Performance Client Reference Form Region 11
- Exhibit C-3 Required Certifications and Statements Region 11
- Exhibit C-4 Disclosure of Ownership and Control Interest Statement CMS 1513_Region 11
- Exhibit C-5 Managed Medical Assistance (MMA) Provider Service Network (PSN) Provider Ownership Interest Disclosure Report Region 11
- Exhibit C-6 List of Terminated Contracts Region 11
- Exhibit C-7 Vendor Certification Regarding Scrutinized Companies List Region 11
- Exhibit C-8 - Home Medical Equipment and Supplies Providers List Region 11
- Exhibit C-9 Certification of Drug Free Workplace Program Region 11
- Exhibit E-1 Standard Submission Requirements and Evaluation Criteria Region 11
- Exhibit E-1-A SRC #5 Submission Requirements
- Exhibit E-1-B SRC #7 Submission Requirements
- Exhibit E-2 Standard Quality Measurement Tool Region 11
- Exhibit E-3-B_Provider Network Evaluation Tool_Region 11
- Exhibit E-4 Specialty Submission Requirements and Evaluation Criteria Region 11
- Exhibit E-5 Specialty Quality Measurement Tool Region 11
- Exhibit E-6 Respondent Attestation for Response Submission Region 11
- Exhibit F-2 Base Data Set_Non-LTC Population Region 11
- Exhibit F-3 Inflation Factors Region 11
- Exhibit F-5 SMMC LTC Population MMA Base Data Set Region 11
- Exhibit F-6
- Exhibit F-6_Attachment A-1 - Summary - Non-LTC MMA Data Book Member Months_Region 1
- Exhibit F-6_Attachment A-2a - Summary - Capitated Plan - FFS Data_Region 11
- Exhibit F-6_Attachment A-2b - Summary - Capitated Plan - Financial Data_Region 11
- Exhibit F-6_Attachment A-2c - Summary-Capitated Plan-MH Encounter Data_Region 11
- Exhibit F-6_Attachment A-2d - Summary - Capitated Plan - Hospital and Rx Encounter Data_Region 11
- Exhibit F-6_Attachment A-2e - Summary - Capitated Plan - Dental Encounter Data_Region 11
- Exhibit F-6_Attachment A-2f - Summary - Capitated Plan - Transportation Funding Data_Region 11
- Exhibit F-6_Attachment A-3a - Summary - Non-Capitated PSN - FFS Data_Region 11
- Exhibit F-6_Attachment A-3b - Summary - Non-Capitated PSN - MH Encounter Data_Region 11
- Exhibit F-6_Attachment A-3c - Summary - Non-Capitated PSN - Dental Encounter Data_Region 11
- Exhibit F-6_Attachment A-3d - Summary - Non-Capitated PSN -Transportation Funding Data_Region 11
- Exhibit F-6_Attachment A-4a - Summary - FFS System - FFS Data_Region 11
- Exhibit F-6_Attachment A-4b - Summary - FFS System - MH Encounter Data_Region 11
- Exhibit F-6_Attachment A-4c - Summary - FFS System - Dental Encounter Data_Region 11
- Exhibit F-6_Attachment A-4d - Summary - FFS System -Transportation Funding Data_Region 11
- Exhibit F-6_Attachment A-5a - Database - FFS Data_Region 11
- Exhibit F-6_Attachment A-5b - Database - Capitated Plan Financial Data_Region 11
- Exhibit F-6_Attachment A-5c - Database - Mental Health Encounter Data_Region 11
- Exhibit F-6_Attachment A-5d - Database - Hospital and Rx Encounter Data_Region 11
- Exhibit F-6_Attachment A-5e - Database - Dental Encounter Data_Region 11
- Exhibit F-6_Attachment A-5f - Database - Transportation Funding Data_Region 11
- Exhibit F-6_Attachment B.1 - SMMC MMA Data Summary_Region 11
- Exhibit F-6-D- Databook Service Mapping
- Exhibit F-9 Supplemental Information Region 11
- Exhibit F-10 Capitated Plan Cost Proposal Region 11
- Exhibit F-11 Non-Capitated Cost Proposal Region 11
The above list of attachments are provided in secured Word, Excel and PDF documents. Any alteration and/or modification to the Agency approved forms will result in the Agency’s rejection of the vendor’s response.
As a reminder, parties interested in responding to AHCA ITN 027-12/13. must view the entire solicitation on the VBS website. To view the solicitation, search the Agency for Health Care Administration’s active competitive solicitations and select AHCA ITN 027-12/13.
AHCA RFP 028-12/13
Respondents to AHCA RFP 028-12/13, Medicaid Managed Care External Quality Review (EQR) Program, shall utilize the following Agency approved attachments for submission of its response and shall adhere to the instructions contained within each respective attachment::
- Attachment E-1 - Submission Requirements
- Attachment F - Past Performance
- Attachment G - Required Certifications 09-11
- Attachment I - Drug-Free Workplace
- Attachment J - Cost Proposal
- Attachment J-1, REVISED Detailed Budget
- Attachment J-2 - Renewal Period Cost Proposal
- Attachment J-3, REVISED Detailed Budget
- Attachment K - Required Statements
- Attachment L - Scrutinized Company certification
The above list of attachments are provided in secured Word documents. Any alteration and/or modification to the Agency approved forms will result in the Agency’s rejection of the vendor’s response.
As a reminder, parties interested in responding to AHCA RFP 028-12/13. must view the entire solicitation on the VBS website. To view the solicitation, search the Agency for Health Care Administration’s active competitive solicitations and select AHCA RFP 028-12/13.
