This week, our In Focus section reviews the request for proposals (RFP) released by the New Mexico Human Services Department (HSD) to reprocure contracts for the state’s Medicaid managed care program in its second phase, Centennial Care 2.0. Centennial Care provides integrated Medicaid managed care coverage, including long-term services and supports (LTSS) and behavioral health, to nearly 700,000 Medicaid beneficiaries in the state, with annual spending of roughly $4.5 billion.
Centennial Care 2.0 will cover the majority of New Mexico Medicaid beneficiaries, with the exception of:
- Native Americans, not receiving LTSS or who have opted out of managed care;
- Individuals residing in an Intermediate Care Facility for Individuals with Intellectual Disabilities (ICF-IID);
- Partial benefit enrollees;
- Members of the Program of All Inclusive Care for the Elderly (PACE);
- Individuals with intellectual and developmental disabilities (I/DD) in a home and community based services (HCBS) waiver; and
- Select other HCBS waiver recipients.
Out of more than 877,000 Medicaid beneficiaries in New Mexico, roughly 88,000 are in fee-for-service (FFS) as full benefit enrollees, with another 117,000 partial benefit enrollees. When fully implemented in 2019, Centennial Care 2.0 anticipates covering roughly 700,000 beneficiaries in total.
Contract Awards, Terms
New Mexico’s HSD intends to award between three and five statewide contracts to serve Centennial Care 2.0; the state currently contracts with four MCOs. Contracts are scheduled to run from March, 2018, through December 31, 2022. Based on an implementation date of January 1, 2019, this equates to a four-year contract term, with an option to extend for one additional year, through 2023.
The majority of points available to bidders are in the technical proposal section, and it should be noted there is a cost component of the bid. Additional points are included in the scoring criteria for finalist oral presentations.
There is a mandatory acknowledgement of receipt due on September 18, ahead of a mandatory pre-proposal conference on September 19. Proposals are due to HSD on November 3, with finalists to be selected on December 22. Notices of intent to award will be announced on January 8, 2018, with final contracts awarded on March 15, 2018. Implementation is set for January 1, 2018.
Current Medicaid Managed Care Market
Molina and Presbyterian are the two largest MCOs in the current Centennial Care program, each with roughly one-third of the market.