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Government Programs & The Uninsured

Minnesota releases Medicaid RFP for 80 counties outside Twin Cities

This week our In Focus section reviews the Minnesota request for proposals (RFP) for Families and Children Medical Assistance (MA), the state’s traditional Medicaid managed care program, and MinnesotaCare, the state’s Basic Health Program (BHP), in 80 counties outside of the Twin Cities seven-county region. The RFP was released by Minnesota Department of Human Services, Purchasing and Service Delivery Division on January 18, 2022. Contracts will begin January 1, 2023, covering approximately 470,000 members.

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CMS seeks new direction for Medicare Advantage and Part D on health equity and dual eligible integration

This week, our In Focus section highlights the Centers for Medicare & Medicaid Services (CMS) proposed changes to the Medicare Advantage (MA) and Part D programs for contract year 2023 and how these changes may impact plan applications, bid submissions, and market dynamics for future years. The analysis and insight reflect the combined expertise of HMA and its companies including the Wakely Consulting Group and The Moran Company.

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MS Releases MississippiCAN, CHIP RFQ

This week, our In Focus reviews the Mississippi request for qualifications (RFQ) for the state’s traditional Mississippi Coordinated Access Network (MississippiCAN) Medicaid program and the state Children’s Health Insurance Program (CHIP). The RFQ, released by the Mississippi Division of Medicaid on December 10, 2021, seeks two to three health plans to serve roughly 480,000 individuals. This is the first time the state is seeking plans, which it refers to as Coordinated Care Organizations (CCOs), to jointly administer MississippiCAN and CHIP.

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District of Columbia releases Medicaid Managed Care RFP

This week, our In Focus section reviews the District of Columbia (DC) Medicaid managed care request for proposals (RFP), released on November 19, 2021, by the District of Columbia Department of Health Care Finance. The procurement will cover DC Healthy Families Program (DCHFP), including adults with special health care needs; District of Columbia Healthcare Alliance Program (Alliance); and Immigrant Children’s Program (ICP). DC expects to award contracts to up to three managed care organizations (MCOs), covering physical, behavioral health, and pharmacy services. Contract approval is expected by June 2022 and implementation in October 2022.

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Missouri Releases Medicaid Managed Care RFP

This week our In Focus reviews the Missouri MO HealthNet (MHD) Medicaid Managed Care Program request for proposals (RFP), released on November 19, 2021, by the Department of Social Services (DSS). The MHD managed care program serves about 850,000 Medicaid and Children’s Health Insurance Program (CHIP) members including the state’s newly implemented Medicaid expansion population, across all regions of Missouri. Missouri’s General Plan managed care program covers TANF, CHIP, expansion and similar eligibility groups but does not include individuals with disabilities or those over age 65.  The RFP also contains a separate section for a single, statewide Specialty Plan for foster children and children receiving adoption subsidy assistance. Managed care organizations must bid on and win a General Plan contract in order to be eligible for the Specialty Plan contract.

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Rhode Island releases Medicaid managed care RFQ

This week our In Focus reviews the Rhode Island Medicaid managed care request for qualifications (RFQ), released on November 12, 2021, by the Executive Office of Health and Human Services (EOHHS). Contracts are worth approximately $1.4 billion annually and cover over 300,000 individuals.

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Minnesota releases RFPs for Senior Health Options and Special Needs Basic Care

This week our In Focus reviews Minnesota Department of Human Services (DHS) requests for proposals (RFPs) for two of the state’s Medicaid managed care programs: Minnesota Senior Health Options/Minnesota Senior Care Plus and Special Needs BasicCare/Integrated Special Needs BasicCare. Both RFPs, released on October 25, 2021, cover health care services in all 87 Minnesota counties.

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