Specifications include, but are not limited to: Provide Statewide MaineCare Disability Determination Services, which include: Disability/Blindness Determinations; Reconsiderations and Continuing Disability Reviews (CDRs); and Maintaining all standards of the Department in accordance with the requirements of this RFP. Maintain a facility location(s) where Disability Determinations Services will be provided at a minimum during regular business hours; Monday – Friday between 8:00 a.m. and 5:00 p.m. EST, excluding State Holidays and administrative closings. Ensure adequate office equipment is available for Disability Determinations, considering the anticipated number of requests for Disability/Blindness Determinations, Reconsiderations, and CDRs to be processed. Ensure the facility has adequate security and confidentiality measures for all Applicant/Member Disability Packets and related information. Maintain a Medical Review Team (MRT) and support staff to carry out the required Disability/Blindness Determination duties, considering fluctuations in the number of Disability Determination requests received that may occur over the course of each contract period. Generate standard forms and notices from ACES or other means as directed by the Department to carry out all noticing and evidence gathering obligations under this RFP. Alternative forms and notices must be approved in writing by the Department prior to use. Disability/Blindness Determinations, Reconsiderations, and CDRs Service Delivery - Conduct Disability/Blindness Determinations, Reconsiderations, and CDRs for Applicants/Members within forty-five (45) calendar days from receipt of the Disability Packet. Obtain and review each Applicant/Member Disability Packet, Reconsideration, or CDR by utilizing the electronic systems operated and maintained by the Department, including ACES, DocuWare, and Siebel, ensuring each Determination: Aligns with processes and standards set out in rule by the Social Security Administration (SSA) under the authority of the Social Security Act for matters related to: Evidence development (20 C.F.R. §§ 416.912 – 918); and Disability/Blindness Determinations (20 C.F.R. §§ 416.920 – 986). Aligns with 10-144 C.M.R. C h. 332, Part 6 for matters related to time standards associated with Disability/Blindness Determinations, Reconsiderations, and CDRs. Provide a final and, where appropriate, Presumptive Disability/Blindness Determinations to the Department within five (5) calendar days.
