AHCA releases Florida Medicaid Managed Care re-procurement RFI

The Agency for Health Care Administration (AHCA) released a request for information (RFI) late last week in preparation of the upcoming Statewide Medicaid Managed Care (SMMC) re-procurement process later this year. 

 

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“The Agency is seeking information from entities and stakeholders with direct experience in the managed health and long-term care industries regarding best practices and innovations in business models as well as service delivery for Medicaid managed care,” the RFI reads. 

AHCA first implemented the SMMC program in 2013 and 2014, contracting for managed long-term care and managed medical assistance services. The agency must re-procure managed care contracts every six years. The last re-procurement occurred in 2017, meaning the next cycle will begin in 2022. 

As of March 2022, over 5.1 million Floridians are enrolled in Medicaid. Of that, four million are under the SMMC program. AHCA currently contracts with 12 health plans for several health services, including behavioral health, case management, and community resources. 

AHCA outlined several initiatives that stakeholders may address in their responses. One involves “improving birth outcomes for mothers and infants through and beyond [the] 12-month postpartum coverage period.”

During the 2021 legislative session, legislators passed Senate Bill 2518, which extended postpartum Medicaid eligibility from 60 days to 12 months.  AHCA submitted an 1115 Managed Medical Assistance Waiver amendment request in July 2021 to implement this change and is waiting on CMS approval. 

Another area AHCA is prioritizing for re-procurement is the delivery of home and community based (HCBS) services. Funding was made available for these services through increased federal matching assistance percentages under the American Rescue Plan Act in 2021. 

Florida submitted a $1.1 billion spending plan for these programs designed to support individuals with disabilities and support aging-in-place services. Part of the funds were approved for distribution in December 2021, and the remainder approved within the last week. AHCA is in the process of accepting HCBS provider applications for funding. 

AHCA is accepting clarifying questions about the RFI through May 13th, 2022, and will post replies via the Vendor Information Portal by May 20th, 2022. Responses to the RFI are due at 5:00 p.m. Eastern Standard Time on June 3rd, 2022. 

Responses may be used for research purposes and to help develop a scope of services provided under the new procurement contract, which is scheduled to release in September 2022.