Government Contract | Missouri
MO HealthNet Managed Care

Bid Information

Bid Alert No: 00000561398

Bid Title: MO HealthNet Managed Care

Agency Bid No. Title: RFPS30034901600685

Received Date: 05/05/2016

Close Date: 06/01/2016

Purchase Type: May 1, 2017 through June 30, 2018

Delivery Point:

Delivery Date: Not Stated


Specifications include, but are not limited to:General Requirements:The contractor (hereinafter referred to as the "health plan") shall provide a managed care medical service delivery system for the Department of Social Services, MO HealthNet Division (hereinafter referred to as the "state agency"), located in the State of Missouri in accordance with the provisions and requirements stated herein.The health plan shall adhere to all applicable local, State and Federal requirements regarding operation of the MO HealthNet Managed Care Program.The health plan shall cooperate with the state agency, as directed, in the implementation of the requirements of the Federal or State law. Any Federal or State law requirements altering the obligations of the health plan under the contract shall be accomplished through contract provisions, which may differ from the terms of the contract, to the extent that relevant Federal guidance is issued after the effective date of the contract; or through a contract amendment, as required herein, to the extent that relevant Federal guidance is issued during the term of the contract. The state agency may implement ACA requirements that impact the health plans operations, but do not directly alter its contractual obligations, through the issuance of a provider bulletin.Prior to performing services in each of the counties, the health plan shall:Have and maintain a certificate of authority from the Department of Insurance, Financial Institutions & Professional Registration to establish and operate a health maintenance organization (HMO) in all the counties specified herein by no later than January 10, 2017 so that the state agency can proceed with open enrollment with only health plans that are appropriately licensed. In the event the health plan fails to achieve appropriate licensure by January 10, 2017, the contract shall be cancelled in its entirety.Understand that Federal approval of the contract is required prior to commitment of the Federal financing share of funds under the contract.Participate in readiness reviews. As a result of the extension of Managed Care statewide, the state agency shall conduct an on-site readiness review of all health plans in order to document the status of the health plan with respect to meeting the requirements outlined herein. The implementation plan, as submitted in the health plans awarded proposal, and adherence to the implementation plan shall be monitored by the state agency as part of readiness review activities.The readiness review shall include a review of targeted requirements outlined in the contract, including but not limited to, the health plans provider network, the health plans care management and disease management program, and any other requirements of interest identified by the state agency. The requirements covered within the readiness review shall be determined at the state agencys discretion and communicated accordingly with the health plan prior to the onsite review. The health plan shall submit all necessary requested documentation and complete a self-reporting tool to be submitted to the state agency. The health plan is subject to a desk audit validation of the submitted documentation. In addition to the readiness review, the state agency maintains the discretion to conduct an annual review of these areas. Any tools used by the state agency in the readiness review are subject to review and modifications by the state agency at the state agencys discretion.

Product Code: 95856

Agency Information

Issuing Agency: State of Missouri - Office of Administration

State: Missouri

Agency Type: State and Local

Contact: Laura Ortmeyer, Division of Purchasing and Materials Management Division of Purchasing and Materials Management, 301 West High Street, Room 630, Jefferson City, Missouri, 65101

Phone: 573-751-4579




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