Specifications include, but are not limited to: 2.2.1. Actuarial Support to the State for development of forms required by CMMI as part of the reporting process for the Vermont All-Payer ACO Model Agreement.: 1) The State of Vermont is required to provide CMMI with actuarially supported documents as part of its All-Payer ACO Model Agreement. These forms could include templates provided by CMMI and certified by actuaries that indicate the performance of the Vermont Medicaid Next Generation Program or Vermont’s health care system. The Contractor will complete these forms on behalf of the State of Vermont and provide actuarial memos describing the methodology used to complete them.; a. The Contractor will only perform this activity if requested by the State.; b. The Contractor will provide an estimate for the cost and time necessary to complete this work as requested by the State.; c. The Contractor will provide the documents by the federal deadline.; d. The State will provide explicit written approval of these activities.; 2.2.2. Actuarial support to DVHA for the research, design, and implementation of Vermont All-Payer ACO Model Agreement pursuant to section 3021 of the Affordable Care Act.: 1) Vermont’s All-Payer ACO Model Agreement requires specific State activities, some of which must be supported by actuarial reports and analyses. The State will require actuarial analyses to support its ongoing waiver research, design, and implementation of the current agreement and any potential successor agreements.; a. The Contractor will only perform this activity if requested by the State.; b. The Contractor will provide an estimate for the cost and time necessary to complete this work as requested by the State.; c. The State will provide explicit written approval of these activities.; 2.2.3. Actuarial Support to DVHA for the development and certification of Accountable Care Organization rates for the 2023 and 2024 Performance Years of the Vermont Medicaid Next Generation Program.: 1) The State of Vermont has entered into a contractual arrangement with an Accountable Care Organization (ACO) to assume accountability for the costs and quality of care for a defined population of Vermont Medicaid beneficiaries. On an annual basis, DVHA will renegotiate rates for prospective ACO payments, and will require actuarial support to: o develop appropriate rates; o to communicate methodological considerations with the ACO and their actuaries in support of contract negotiations; o to participate in contract negotiation sessions to advise DVHA, and to certify final rates (and provide accompanying documentation); o The State will require actuarial analyses to support its VMNG rate development and certification.; a. The Contractor will only perform this activity if requested by the State.; b. The Contractor will provide an estimate for the cost and time necessary to complete this work as requested by the State.; c. The State will provide explicit written approval of these activities.
