MDH releases RFP for Medicaid dental benefits administrator
The Maryland Department of Health (MDH) announced a request for proposals (RFP) Tuesday for a contractor to administer dental benefits to eligible Maryland Medicaid beneficiaries. MDH plans to grant a single award through the RFP.
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The search for a Dental Benefits Administrator (DBA) or Dental Administrative Services Organization (DASO) follows the passage of House Bill 6/Senate Bill 150 during the last legislative session, which requires the Maryland Medical Assistance Program to provide dental services to eligible adults beginning January 1st, 2023. Since 2019, adults on Medicaid received dental services through a pilot program. The bill requires Medicaid to cover diagnostic, preventative, restorative, and periodontal services for adults with incomes at or below 133% of the federal poverty level.
The contract will also expand benefits to target populations that are currently under the Maryland Healthy Smiles Dental Program (MHSDP). These include children under the age of 21, pregnant and postpartum women 21 years of age and older, and adults 21-64 who are dually-eligible for Medicaid and Medicare. Approximately 1.5 million Marylanders are currently eligible for MHSDP services, according to the RFP.
“The services provided under the contract will play a crucial role in ensuring the continuation of providing quality services to this MHSDP population,” the RFP said.
Some of the contractor’s responsibilities will include remaining in compliance with CMS certifications, Maryland’s “Information Technology Security Policy and Standards,” and HIPAA compliance standards. The contractor will also be responsible for providing outreach to the target communities above to inform them of their dental benefits and ensure project staff and providers are properly trained for the dental program.
Regarding program utilization, the contractor should achieve at least a 1 percentage point increase per contract year for preventive and restorative services and produce utilization reports at least annually to MDH by January 15th.
The contract will be split into 4 phases. First is the implementation phase of the DBA or DASO, which encompasses the period before the program’s go-live date. Phase 2 is the DASO Operations and Maintenance Phase, which will span from the go-live date until the end of the contracts. The RFP notes the contract will comprise of a 2-year base operation and maintenance period and 3 1-year option periods. Phase 3 will be the DASO End of Contract Transition Phase, which begins 6 months before the contract termination date. Finally, Phase 4 will consist of DASO future activities at the request of MDH.
A pre-proposal conference will be held virtually on September 10th, at 11 am Eastern Time.
“Attendance at the conference is not mandatory, but all interested parties are encouraged to attend in order to facilitate better preparation of their proposals,” the RFP said. “…It is highly recommended that ALL Prime Contractors bring their intended subcontractors to the Conference/Site Visit to ensure that all parties understand the requirements of the Contract.”
Questions about the RFP should be directed to MDH by November 15th, 2022, at 2 pm Eastern Time.
Responses are due to MDH procurement officer Calvin Johnson by Monday, November 22nd, 2022, at 2 pm Eastern Time, and must be submitted electronically through the eMaryland Marketplace.