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.
Minnesota recently awarded separate contracts for the Twin Cities metro area, worth $3.87 billion and serving 600,000 members, to Blue Plus, HealthPartners, Hennepin Health, Medica, UCare, and UnitedHealthcare. Proposals for the Minnesota Senior Health Options/Minnesota Senior Care Plus and Special Needs BasicCare/Integrated Special Needs BasicCare procurements, released this past October, are due February 18, 2022.
Families and Children MA covers low-income pregnant woman, children under 21, adults with children, and adults under the age of 65 without children who meet eligibility requirements. MinnesotaCare is a BHP that covers individuals who are at or below 200 percent of the federal poverty level, are not enrolled in Medicare, and do not have access to employer-subsidized insurance. MinnesotaCare requires its enrollees to pay a premium, with the exception of children.
This procurement will cover the following counties: Aitkin, Becker, Beltrami, Benton, Big Stone, Blue Earth, Brown, Carlton, Cass, Chippewa, Chisago, Clay, Clearwater, Cook, Cottonwood, Crow Wing, Dodge, Douglas, Faribault, Fillmore, Freeborn, Goodhue, Grant, Houston, Hubbard, Isanti, Itasca, Jackson, Kanabec, Kandiyohi, Kittson, Koochiching, Lac qui Parle, Lake, Lake of the Woods, Le Sueur, Lincoln, Lyon, McLeod, Mahnomen, Marshall, Martin, Meeker, Mille Lacs, Morrison, Mower, Murray, Nicollet, Nobles, Norman, Olmsted, Otter Tail, Pennington, Pine, Pipestone, Polk, Pope, Red Lake, Redwood, Renville, Rice, Rock, Roseau, St. Louis, Sherburne, Sibley, Stearns, Steele, Stevens, Swift, Todd, Traverse, Wabasha, Wadena, Waseca, Watonwan, Wilkin, Winona, Wright, and Yellow Medicine.
The state will award contracts to at least two managed care organizations (MCOs) in each county. MCOs that submit a proposal must submit for all counties in which they are licensed to serve the entire county. MCOs are also required to participate in the MinnesotaCare program in service areas where they participate in the MA program.
Under Minnesota law, plans must participate in the MA and MinnesotaCare program as a condition of participating in state and local government employee health insurance programs, the workers’ compensation system, and insurance plans provided through the Minnesota Comprehensive Health Association (MCHA).
Proposals are due April 1, 2022, with awards expected June 24, 2022. Contracts will run from January 1, 2023, through December 31, 2023, with five optional years.
Incumbents are Blue Plus/BCBS of Minnesota, Health Partners, IMCare, PrimeWest Health, South Country Health Alliance, and UCare Minnesota, serving nearly 470,000 members.
Proposals will be evaluated in three phases:
- Required Statements and Forms Review
- Evaluation of Technical Requirements of Proposals and Readiness Review
- Selection of the Successful Responder
Technical proposals will be scored out of 105 points, as follows:
A proposal must receive a final total score of 50 or greater to pass.