MM Curator summary
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[MM Curator Summary]: Winners – BCBS, Presby, UHC and Molina.
SANTA FE – Today, the New Mexico Human Services Department (HSD) announced its intention to award Medicaid managed care organization (MCO) contracts to four health plans for Turquoise Care, the state’s Medicaid managed care program. The state will negotiate contracts with BlueCross BlueShield, Presbyterian Health Plan, United Health Plan, and Molina Health Plan with a start date of July 1, 2024. The state announced that it does not intend to negotiate a Medicaid contract with current MCO Western Sky Community Care.
The Human Services Department also announced a decision to rescind the cancellation of the Turquoise Care Request for Proposals (RFP), which was made on January 30, 2023, to allow agency leadership an opportunity to assess the design of the procurement.
“HSD spent the past several months reviewing the MCO contracts in depth and making improvements that focus on advancing and incentivizing health plan performance and ensuring that Medicaid customers have access to this information when they pick their health plan,” said HSD Acting Secretary Kari Armijo. “We will be negotiating contracts that reflect these improvements with the expectation of achieving better health outcomes for Medicaid customers.”
HSD has engaged with a consultant to make recommendations for improving MCO contract enforcement and compliance, and the agency is making several contract improvements with the existing health plans that will go into effect September 2023.
The new go-live date for the MCO contracts is July 1, 2024, a change from the original planned go-live date of January 1, 2024. The extension will allow HSD to complete the Medicaid unwinding, which requires a full recertification of every Medicaid customer over a 12-month period that extends through March 2024. This process was suspended during the COVID-19 Public Health Emergency. Open enrollment for the new MCO contracts will begin in April 2024 after the unwinding is complete.
“The new contract go-live date will minimize disruption for Medicaid customers by allowing HSD to focus on the important work of recertifying eligibility for the 934,305 customers who are enrolled in the program,” said Armijo. “We want all Medicaid customers to be watching for their turquoise envelopes and submitting the required paperwork to make sure they stay covered if eligible and to help them transition to other health insurance coverage if they no longer qualify for Medicaid.”
Medicaid customers can learn more about how to renew their Medicaid coverage by visiting HSD’s Renew New Mexico! website at renew.hsd.nm.gov or by calling HSD at 1-800-283-4465.
We talk, interpret and smile in all languages. We provide written information to our customers in both English and Spanish and interpretation services are available in 58 languages through our provider, CTS Language Link. For our hearing, and speech impaired customers, we utilize Relay New Mexico, a free 24-hour service that ensures equal communication access via the telephone to individuals who are deaf, hard of hearing, deaf-blind or speech disabled.
The Human Services Department provides services and benefits to 1,046,816 New Mexicans through several programs including: the Medicaid Program, Temporary Assistance for Needy Families (TANF) Program, Supplemental Nutrition Assistance Program (SNAP), Child Support Program, and several Behavioral Health Services.