Rural Health-Medicaid Primary Accountable Care Transformation (PACT)

The State of South Dakota Department of Social Services seeks a comprehensive case‑management tool to support its Medicaid Primary Accountable Care Transformation (PACT) program across rural, tribal, and frontier health‑care settings. The solution must enable care coordination, longitudinal member records, referral tracking, and analytics while integrating with existing state health systems via HL7/FHIR standards. Vendors may propose State‑hosted Azure PaaS, vendor‑hosted SaaS, or on‑premise options, must meet stringent security (PCI‑DSS, NIST 800‑53 Moderate, CMS ARS) and data‑retention (10‑year) requirements, and provide a four‑tier support model, training, and a fixed‑fee Maintenance & Operations arrangement. • Core functional scope: case‑management, care‑gap identification, referral intake, alerts, and reporting for ~20 k Medicaid members and up to 4 k justice‑involved youth. • Technical scope: HL7 v2.x & FHIR R5 interoperability, Azure PaaS preferred hosting, US‑data residency, multi‑environment (dev, test, UAT, prod) deployment, and 99.9 % uptime SLA. • Compliance & security: PCI‑DSS, NIST 800‑53 Rev 5 Moderate, CMS ARS v5.2, SOC 2 Type II/HITRUST, MFA, audit‑log retention ≥ 7 years, and all development performed within the United States.