Currently contracted Managed Care Organizations (MCOs) for the MSHO/MSC+ contract must respond to this RFP in order to be considered for selection to continue providing benefits through the MSHO/MSC+ contract.

Responders who are currently operating MSHO and MSC+ in a county will be selected to participate if they meet the minimum requirements of this RFP. Additional Responders may be selected to participate based on scoring and county preferences and if the Responders meet the minimum requirements of this RFP.

A Responder is required to submit a proposal in good faith that meets the requirements of this RFP provided that the requirements can be reasonably met by the Responder to serve individuals eligible for the programs in a geographic region of the State. To be eligible to respond to this RFP, Responders must meet all of the following criteria and fulfill all of the requirements included in this RFP.

(a) Managed Care Organization Definition
To be considered a qualified Managed Care Organization (MCO) for purposes of responding to this RFP, a successful Responder must meet the definition of an MCO. Under the federal rule governing managed care, MCO means an entity that has, or is seeking to qualify for, a comprehensive risk contract, and that is:
i. A Federally Qualified HMO that meets the advance directives requirements of 42 C.F.R. §§ 489.100-104; or
ii. Any public or private entity that meets the advance directives requirements and is determined to also meet the following conditions: a) makes the services it provides to its Medicaid Enrollees as accessible (in terms of timeliness, amount, duration, and scope) as those services are to other Medicaid enrollees covered under the fee-for-service program within the area served by the entity, and b) meets the solvency standards of 42 C.F.R. § 438.116.

(b) Health Maintenance Organization
Health maintenance organization (HMO) means a foreign or domestic corporation or a local governmental unit as defined in Minnesota Statutes, section 62D.02, subdivision 11, controlled and operated as provided in Minn. Stat. §§ 62D.01-30, which provides, either directly or through arrangements with providers or other persons, comprehensive health maintenance services, or arranges for the provision of these services, to enrollees on the basis of a fixed prepaid sum without regard to the frequency or extent of services furnished to any particular enrollee.

(c) Dual Special Needs Plan
Applicants for Medicare Advantage dual-eligible Special Needs Plans (D-SNPs) (initial, existing, and existing/expanding) must have a signed State Medicaid Agency contract by the deadline specified by the Centers for Medicare and Medicaid Services (CMS). A current evergreen, multiyear, or future contract must be uploaded to CMS each application cycle or year. Responders for Integrated SNBC must promptly submit a Notice of Intent to Apply (NOIA) to CMS and actively seek a Dual Special Needs Plan contract with CMS limited to the SNBC population under a unique H number. As noted in the CMS HPMS memo regarding Notice of Intent to Apply issued October 15, 2021, “[w]here state Medicaid agencies request (or plan to request) that D-SNPs have separate contract numbers, organizations may submit a NOIA while we work with the state.”

Note: Responders who do not currently have a contract for SNBC are encouraged to contact Kristi Burt prior to submitting a NOIA to CMS to begin working through the requirements to bring up a new Medicare Advantage dual-eligible Special Needs Plan.

A Responders’ Conference will be held on December 3, 2021, at 9:00 a.m. Central Time. The conference will serve as an opportunity for Responders to ask specific questions of State staff concerning the project. Oral answers given at the conference will be non-binding. Attendance at the Responders’ Conference is not mandatory but is recommended. Responders will attend via WebEx call. Responders must register to attend the Responders’ Conference.

To register, send an email to the email address in Contact Information below. Provide the name, email address, organization and any needed accommodations for each attendee.

An invitation will be sent to all registered attendees no later than close of business on December 1, 2021.

Proposals must be physically received (not postmarked) by 4:00 p.m. Central Time on February 18, 2022 to be considered.

Summary of Important Dates:
- State Register Notice/RFP Published on DHS Website: October 25, 2021
- Questions Due for Responders’ Conference: November 19, 2021
- Registration for Responders’ Conference Deadline: November 19, 2021
- Responders’ Conference: December 3, 2021
- Final RFP Questions Due: December 30, 2021
- All RFP Questions Answered and Posted on DHS Website: January 20, 2022
- Complete RFP Proposals Due: February 18, 2022
- Readiness Review (if applicable): March - September 2022
- Notice of Intent to Contract: Anticipated May 9, 2022
- MIPPA Submission to CMS: July 5, 2022
- Contract Negotiations: August and September 2022
- Start of Contract: January 1, 2023

Responders’ questions regarding this RFP must be submitted in writing prior to 4:00 p.m. Central Time on December 30, 2021. Every effort will be made to provide answers, within fourteen (14) days of receiving a question. Responses to all RFP questions will be posted no later than January 20, 2022.