MM Curator summary
The article below has been highlighted and summarized by our research team. It is provided here for member convenience as part of our Curator service.
[MM Curator Summary]: The new RFP will require a pretty decent network. One with actual contracted providers, not just LOIs.
LANSING — The Michigan Department of Health and Human Services has provided new information related to the rebidding of contracts for health plans that provide services to 2.2 million Michiganders receiving coverage through Medicaid and Michigan’s Healthy Michigan Plan.
MDHHS is announcing network requirements and minimum qualifications for bidders in its upcoming request for proposals for the Comprehensive Health Care Program contract for Michigan’s Medicaid health plans.
“We want to provide Michiganders served by Medicaid health plans with a more equitable, coordinated and person-centered system of care,” said Elizabeth Hertel, MDHHS director. “Through this rebid process, MDHHS seeks to provide improved affordable health care coverage for Michiganders served by Medicaid health plans.”
The contract is being rebid during fiscal year 2024, which begins Oct. 1, with new contracts beginning in fiscal year 2025. The rebid is part of MIHealthyLife, an initiative to strengthen Medicaid services informed by input from nearly 10,000 enrollees and family members, health care providers, health plans and other community partners.
Consistent with federal standards and input from MIHealthyLife stakeholders, the rebid will include updates to Michigan’s Medicaid Health Plan network adequacy and timely access standards, which can be found at Michigan.gov/MDHHS/MIHealthyLife.
When determining whether these standards are met, MDHHS will only consider providers with whom bidders have executed contracts at the time of bid submission. MDHHS is releasing its updates to the Comprehensive Health Care Program network adequacy and timely access standards in advance of the rebid to provide time for potential bidders to review their provider networks and execute provider contracts necessary to meet the new standards.
MDHHS’s new Medicaid Health plan network adequacy and timely access standards can be found at Michigan.gov/MDHHS/MIHealthyLife, along with mandatory minimum requirements Medicaid Health Plans must meet in order to qualify for review under the rebid.
In addition, the request for proposals will incorporate several Comprehensive Health Care Program changes intended to advance the MIHealthyLife pillars. These include:
— A commitment to health equity demonstrated by plans achieving the NCQAs Health Equity Accreditation, beginning the process no later than Oct. 1, 2024.
— A strong emphasis on addressing social determinants of health demonstrated by investment and engagement with community-based organizations.
— Efforts to increase childhood vaccination rates, including increasing provider participation in the Vaccines for Children Program.
— Adoption over time of a more person-centered approach to mental health care coverage.
The Medicaid Health Plan request for proposals will be posted to the SIGMA system in fall 2023, with responses due in January 2024. New contracts resulting from this rebid are scheduled to begin on Oct. 1, 2024. MDHHS reserves the right to change mandatory minimum requirements, dates or any other information deemed necessary.
Go online to Michigan.gov/MDHHS/MIHealthyLife for more information.
Questions about MIHealthyLife can also be sent directly to mdhhs-mihealthylife@michigan.gov.
Procurement-related questions can be sent to Samuelb@michigan.gov.
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