MM Curator summary
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[MM Curator Summary]: We would like a break from the pain of the procurement process, please.
The Agency for Health Care Administration (AHCA) won’t provide additional insights into its Statewide Medicaid Managed Care program until after July 4.
The state issued an “informational memo” Thursday afternoon with the announcement after a tentative June 27 deadline for it to respond to written questions about its invitation to negotiation (ITN) for the Statewide Medicaid Managed Care program came and went with no action. The brief notice says the agency’s responses to written questions will be included in an addendum to the ITN that won’t be published until “after the July 4 holiday.”
AHCA released the mammoth 956-page ITN in April. Interested parties were required to submit any questions they had about the ITN to the agency by May 3.
The questions, and the names of the entities that submitted them, are public records. Florida Politics first requested the information from AHCA in May, but the agency has not provided the requested information.
Some Medicaid managed care plan executives and lobbyists told Florida Politics in April they were surprised by a provision in the ITN regarding enrolling individuals with intellectual or developmental disabilities into the Statewide Medicaid Managed Care program.
The ITN puts an increased emphasis on the delivery of behavioral health services and, according to the ITN, the agency intends to award contracts to “nationally accredited plans that offer an enhanced delivery system and integration of behavioral and physical health services.”
Florida’s existing managed care contracts expire on Dec. 31, 2024, and the ITN sets an ambitious timeline to ensure new contracts are negotiated, signed and executed by then. To that end, entities interested in participating in the program must submit their bids by noon on Aug. 15. The state anticipates holding a public opening of the bids at 3 p.m. the same day.
AHCA will invite 10 entities to negotiate for the Medicaid managed care contracts. The contracts are worth tens of billions of dollars to the entities that submit winning bids. Managed care plans and other managed provider networks that aren’t chosen to participate in the program are essentially locked out of Florida’s $38 billion Medicaid program until December 2030.
This is the third time the state has put its Statewide Medicaid Managed Care program up for competitive bid. According to the ITN, AHCA has used its past experiences to help inform the managed care networks it’s looking to contract with. But the third procurement does bring with it some changes. The number of Medicaid regions in the new ITN has been cut from 11 to nine and the numerical names for the regions have been replaced with letter names. The changes are a result of operational changes the Legislature agreed to pass in the 2022 Session.
Additionally, AHCA is allowed to award Medicaid managed care contracts on either a statewide or regional basis. For the first two procurements, AHCA was required to award regional contracts, only.
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