First Amendment to the Iowa Department of Human Services 
Iowa Dental Wellness Plan and Hawki Dental Pre-Paid Ambulatory Health Plan (PAHP)
 Request for Proposal

This Amendment to RFP Number MED-24-004 is effective as of June 21, 2023.  The RFP is amended as follows:

Revision 1.  The following language from the title page and RFP Section 2, Subsection 2.1, is hereby amended to read as follows:
RFP_MED_24_004@dhs.state.ia.us 
RFP_MED_24_004@dhs.state.ia.us

Revision 2.  The following language in the Procurement Timetable is hereby amended to read as follows:
Agency Posts Scoring Guide and Technical Proposal Components	On or Around June 23, 2023	

Revision 3.  The following language from Attachment F, Section 2, Subsection A.07.e.14 is hereby amended to read as follows:
Program Integrity Manager and Special Investigations Unit Staffing.  Shall ensure oversight of the Contractor’s SIU activity. The Contractor shall ensure that their Program Integrity Manager has demonstrated experience in providing leadership, oversight and direction in the development and implementation of Medicaid Managed Care program integrity programs. The Program Integrity Manager shall lead the implementation of strategic direction from State of Iowa Medicaid program administrators and leadership. The Program Integrity Manager shall lead collaboration of managed care plan’s program integrity efforts with CMS and federal/state law enforcement partners, including supporting all efforts by Iowa Medicaid to hold providers and suppliers responsible for fraud, waste, and abuse. Specifically, the Program Integrity Manager shall meet the following requirements: 
1)	Demonstrated knowledge and experience in managing health care delivery, program integrity, utilization management, or public health program functions within a large-scale health plan or programs. 
2)	Comprehensive knowledge of laws, policies, and regulations that apply to the administration of Medicaid Managed Care program health care delivery and program integrity. Demonstrated ability to use this knowledge and associated metrics to assess and improve program effectiveness, management processes, and systems to achieve program integrity priorities and results. 
3)	Demonstrated experience, in a senior leadership position working with government agencies and programs, law enforcement organizations, and/or public and private organizations on complex and controversial issues relating to program administration and the protection of the integrity of the Medicaid programs. 
4)	Qualification Requirements: 
•	Graduation from an accredited four-year college or university with a degree in any field (e.g., public or business administration, social work, public health, law, education, engineering), and experience equal to five years of full-time professional-level work in program administration, program development, program operations, or management; or 
•	A total of nine years of combined education and/or full-time experience in any field and profession experience as defined above. 
The Program Integrity Manager will serve as the liaison between the Contractor and State agencies, law enforcement, and federal agencies. The Program Integrity Manager shall be informed of current trends in Fraud, waste, and Abuse as well as mechanisms to detect such activity.  The Program Integrity Manager shall be located in the Iowa offices. The position shall be dedicated at least (one hundred percent) 100% of the time to the oversight and management of the Program Integrity efforts required under the Contract. The Program Integrity Manager shall have open and immediate access to all Claims, Claims processing data and any other electronic or paper information sufficient to meet the requirements of the Agency.  The duties shall include, but not be limited to: (i) oversight of the Program Integrity function under the Contract; (ii) liaison with the Agency in all matters regarding Program Integrity; (iii) development and operations of a Fraud control program within the Contractor Claims payment system; (iv) liaison with Iowa’s MFCU and/or the Office of the Attorney General; (v) assure coordination of efforts with the Agency and other agencies with regards to Program integrity issues.

Revision 4.  The following language from Attachment F, Section 3, Exhibit A, Table A, Performance Standard 3: Initial Oral Health Risk Screening is hereby amended to read as follows:
The percent of unique new Enrolled Members in the DWP-A population, who have been assigned to the Contractor for a continuous period of at least ninety (90) Days during the measurement State fiscal year, that complete an Initial Oral Health Risk Screening using the Oral Health Equity Self-Assessment Tool shall meet or exceed seventy percent (70%).