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Contracts for Services to Minnesota Health Care Organizations
to Provide Health Services to Elderly Adults

Grantees to Provide Prepaid Health Care Services to Eligible Individuals through the Minnesota Senior Health Options and Minnesota Senior Care Plus throughout 87 Counties in the State of Minnesota

Agency Type:

State

Funding Source:

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Minnesota Department of Human Services (DHS) - Purchasing and Service Delivery Division

Conf. Date:

12/03/21

Deadline Date:

02/18/22 4:00 PM Central Time Receipt

Description:

Request a Grant Writer

Contracts for services to Minnesota health care organizations to provide elderly adults with health care services. Selected grantees will provide services to individuals ages 65 and above who are receiving diagnostic, preventive, comprehensive, therapeutic, and rehabilitative health care services.

The Minnesota Department of Human Services (DHS), through its Purchasing and Service Delivery (PSD) Division (State), is seeking Proposals from qualified Responders to provide prepaid health care and long-term care services to people ages 65 and older (seniors) who are enrolled in Medical Assistance under Minnesota Senior Health Options (MSHO) and Minnesota Senior Care Plus (MSC+) programs throughout Minnesota. This Request for Proposals applies to all 87 counties in Minnesota. Responders that provide MSHO in a county must also provide MSC+ in the same county, in order to assure a seamless transition of enrollee choices. Responders may not provide MSC+ as a standalone product in a county.

The Responder must provide access to cost-effective, quality health care to eligible individuals covered under the MSHO/MSC+ Contract. The MSHO/MSC+ model contract includes requirements for enrollment, MCO and enrollee communications, marketing and enrollee education, reporting requirements, access standards, transition services, service authorization, quality assessment and performance improvement, denials, terminations and reductions of service (DTRs), grievances, appeals, and state fair hearings, and other required provisions including compliance with various state and federal laws and regulations. The Responder must comply with the program contract requirements specified in the model contract.

GrantWatch ID#:

GrantWatch ID#: 199502

Term of Contract:

The term of any resulting contract to provide services under MSHO and MSC+ (MSHO/MSC+ contract) is anticipated to be for one (1) year, from January 1, 2023 until December 31, 2023. Thereafter, the State may choose to renew any contract awarded under this RFP annually for up to five (5) years.

Responders contracted by the State under this RFP will be offered for managed care enrollment effective January 1, 2023. This includes being offered as a health plan choice in the Annual Health Plan Selection (AHPS) during October 2022 with an effective managed care enrollment date of January 1, 2023.

Additional Eligibility Criteria:

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.

Pre-proposal Conference:

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.

Pre-Application Information:

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.

Contact Information:

Before starting your grant application, please review the funding source's website listed below for updates/changes/addendums/conferences/LOIs.

Proposals must be delivered to:
Attention: Kristi Burt
Health Care Administration, Purchase and Service Delivery Division
Department of Human Services
444 Lafayette Road N.
St. Paul, MN 55155

All correspondence must be directed to Kristi Burt at the following email address:
SNP_RFPs@state.mn.us

URL for Full Text (RFP):

Geographic Focus:

USA: Minnesota

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