Immigration, Refugees and Citizenship Canada—Interim Federal Health Program

Introduction

Deloitte LLP (Deloitte) was engaged on February 13, 2018 as a Fairness Monitor (FM) to observe the competitive procurement process for the purchase of claims processing services related to the Interim Federal Health Program (IFHP). The IFHP provides limited and temporary healthcare coverage, primarily for eligible refugees and refugee claimants, until they receive provincial or territorial health insurance coverage, or until they leave Canada. This procurement process is being undertaken by Public Services and Procurement Canada (PSPC) on behalf of Immigration, Refugees and Citizenship Canada (IRCC) and was initiated by Letter of Interest (LOI) B8304-180008/A.

Deloitte is an independent third party with respect to this activity.

We reviewed all of the information provided and observed all relevant activities conducted to date.

We hereby submit the Final report covering the activities of the FM, including a review of the following:

• The LOI, which is also identified as Request for Information (RFI) #1 dated April 30, 2018 (published May 1, 2018)
• Industry engagement activities that consisted of an industry day meeting and one-on-one meetings with various interested parties
• Release of the Request for Proposals (RFP) published on June 10, 2019 (B8304-180008/B) and the subsequent five amendments (that included answers to questions from interested parties). The RFP closed on September 13, 2019
• The bid evaluation, which consisted of an evaluation kickoff meeting on September 17, 2019, evaluation consensus meetings on October 11 and 15, 2019, clarification requests issued to the bidder and their responses, an evaluation consensus meeting on November 12, 2019, review of evaluation team documentation on December 12, 2019, and an evaluation consensus wrap-up conference call on December 12, 2019

This report includes our attestation of assurance related to the procurement to date, a summary of the scope and objectives of our assignment, and relevant observations from the activities undertaken.

Attestation of assurance

The Fairness Monitor hereby provides the following unqualified assurance statement concerning the procurement to date of claims processing services related to the Interim Federal Health Program.

It is our professional opinion that the competitive procurement process we observed to date was carried out in a fair, open and transparent manner.

Project requirement

Overview of the project

IRCC is responsible for the IFHP, which provides limited and temporary healthcare coverage, primarily for eligible refugees and refugee claimants, until they receive provincial or territorial health insurance coverage, or until they leave Canada.

On December 15, 2009 a contract was awarded by PSPC on behalf of IRCC to Medavie Inc. (also known as Medavie Blue Cross) to be the claims administrator for the IFHP. The current contract expires on January 16, 2022. A Treasury Board submission was approved in September 2017 for additional funding and time in order to allow for a procurement process to be carried out for the next claims administrator.

Requirements

Canada is seeking to select the next claims administrator for the IFHP. The contractor will need to provide or develop a web-based capturing system to receive electronic and paper-based healthcare claims and migrate data into the claims adjudication system. The contractor will manage and document prior approval requests, adjudicate and pay these claims. They will also be responsible for communicating with all healthcare providers and beneficiaries about coverage and eligibility for services offered in Canada and abroad (also known as Pre-departure Medical Services), operating a contact centre for those healthcare providers and beneficiaries, as well as inputting paper claims into the system.

Objectives of the fairness monitoring assignment and methodology

The Fairness Monitoring Directorate of PSPC required the services of a FM to monitor IRCC’s IFHP claims administration procurement process. The overall objective of the assignment is to provide an independent observation of the process and to provide fairness-related comments to the Contracting Authority, as early as possible, so that appropriate action could be taken before fairness was impacted.

To accomplish the objectives, we undertook the following activities and, where applicable, provided fairness-related comments to the Contracting Authority:

• Familiarized ourselves with the project governance structure and relevant background information
• Reviewed the LOI/RFI documents including industry questions
• Attended preparatory meeting for industry day
• Reviewed industry day session documents
• Attended the industry day session
• Reviewed documentation and questions for one-on-one sessions with vendors
• Attended one-on-one sessions with vendors
• Reviewed draft RFP
• Reviewed the RFP’s five amendments that included answers to questions from potential bidders prior to issuance
• Attended the kickoff meeting for the evaluation phase of the procurement, that included instructions to the evaluators
• Attended evaluation consensus meetings
• Reviewed clarification questions submitted to the bidder, and reviewed the bidder’s response to the questions
• Reviewed evaluation team documentation
• Attended the evaluation consensus wrap-up meeting

Fairness monitoring engagement and observations

Deloitte was engaged as an FM to observe the competitive procurement process for IRCC IFHP claims administration, and to attest to the fairness, openness and transparency of this monitored activity.

In accordance with the terms of our engagement, we familiarized ourselves with the relevant documents, and observed the industry engagement sessions, reviewed RFP documents and amendments and answers to questions from interested parties, attended the evaluation kickoff meeting, attended evaluation consensus meetings, and attended the evaluation consensus wrap-up meeting, and identified fairness-related matters to the contracting and technical authorities and ensured that responses and actions were reasonable and appropriate.

The following describes the FM activities undertaken during the course of the engagement, up to the conclusion of the evaluation phase, and our related observations.

Letter of interest/Request for information #1 release

From April 19, 2018 to April 27, 2018, we reviewed the LOI/RFI #1 documents including Annexes, Appendices and Attachments, and provided fairness-related comments to the Contracting Authority as required. Appropriate action was taken by the Contracting Authority and no fairness deficiencies were identified.

The Request for Information was posted on May 1, 2018 and closed on May 31, 2019.

Questions and answers process

From May 15, 2018 to December 7, 2018 we reviewed the RFI’s five amendments and answers to questions from interested parties, and provided fairness-related comments to the Contracting Authority as required. Appropriate action was taken by the Contracting Authority and no fairness deficiencies were identified.

From May 6 to 10, 2019 Deloitte reviewed additional questions received from interested parties, and provided fairness-related comments to the Contracting Authority as required. Appropriate action was taken by the Contracting Authority and no fairness deficiencies were identified.

Industry engagement

On May 25, 2018 we attended a meeting with IRCC and PSPC to plan and prepare for Industry Day presentations. No fairness deficiencies were identified.

On May 29, 2018 we reviewed presentation materials related to an Industry Day session held on May 30, 2018. No fairness deficiencies were identified.

On May 30, 2018, we attended and observed the Industry Day session. No fairness deficiencies were identified.

On June 14, 15 and 21, 2018 we attended and observed industry engagement sessions related to one-on-one meetings in Ottawa, Ontario. No fairness deficiencies were identified.

Draft statement of work, draft evaluation criteria and draft basis of payment

From December 17, 2018 to April 26, 2019 we reviewed the draft statement of work, draft evaluation criteria and draft basis of payment documents including Annexes, Appendices and Attachments, as well as subsequent responses from industry participants^{Footnote 1}. These draft documents were sent to the registered industry participants in four email releases dated December 17, 2018, January 21, 2019, March 1, 2019 and April 26, 2019. No fairness deficiencies were identified.

Request for proposals release

From June 6, 2019 to June 10, 2019, we reviewed the RFP documents including Annexes, Appendices and Attachments, and provided fairness-related comments to the Contracting Authority as required. Appropriate action was taken by the Contracting Authority and no fairness deficiencies were identified.

The RFP was posted on buyandsell.gc.ca on June 10, 2019 and closed on September 13, 2019.

Request for proposals amendments and questions and answers process

From July 11, 2019 to August 26, 2019 we reviewed the RFP’s five amendments that included answers to questions from interested parties, and provided fairness-related comments to the Contracting Authority as required. Appropriate action was taken by the Contracting Authority and no fairness deficiencies were identified.

Evaluation process

On September 17, 2019 we attended the evaluation kickoff meeting, and no fairness deficiencies were identified.

On October 11 and 15, 2019 we attended evaluation consensus meetings, and provided fairness-related comments to the Contracting Authority as required. Appropriate action was taken by the Contracting Authority and no fairness deficiencies were identified.

On November 7, 2019 we reviewed clarification questions issued to the bidder and the bidder’s responses to those questions, and no fairness deficiencies were identified.

On November 12, 2019 we attended an evaluation consensus meeting, and no fairness deficiencies were identified.

On December 12, 2019 we reviewed evaluation consensus team documentation and attended an evaluation wrap-up conference call. No fairness deficiencies were identified.

No fairness deficiencies were identified in the evaluation process as of the date of this report.

Reference documents

Documents related to LOI/RFI B8304-180008/A are available on CanadaBuys and are summarized in the tables below.

Documents related to RFP B8304-180008/B are available on CanadaBuys and are summarized in the table below.

Addendum to final report, February 14, 2020

This Addendum is related to the Final Report dated February 14, 2020 for the competitive procurement process for the purchase of claims processing services related to the Interim Federal Health Program. 

This Addendum to the Final Report covers the period following the conclusion of the evaluation phase including contract award.

On July 16, 2020 PSPC informed us that on July 8, 2020 they had awarded the contract to the successful bidder. It should be noted that only one bid was received by PSPC related to this procurement process. No fairness deficiencies were identified.

Fairness monitor attestation of assurance

The Fairness Monitor hereby provides the following unqualified assurance statement concerning the procurement of claims processing services related to the Interim Federal Health Program.

It is our professional opinion that the competitive procurement process we observed was carried out in a fair, open and transparent manner.