Missouri BUYS #STATE 0000000463SL

Missouri MO HealthNet Managed Care Program – Statewide Managed Care Services Solicitation

The State of Missouri is seeking proposals for the MO HealthNet Managed Care Program to provide comprehensive managed care services for Medicaid and CHIP populations statewide. - Government Buyer: - Department of Social Services, MO HealthNet Division - Office of Administration, Division of Purchasing - Scope of Services: - Managed care services for families, children, pregnant women, foster care, adoption subsidy, SCHIP, and adult expansion groups - Two plan types: General Plan (all eligible groups) and Specialty Plan (children in state custody with complex needs) - Services include medical, behavioral health, specialty care, care management, and network management - Provider network must include Federally Qualified Health Centers (FQHCs), Rural Health Clinics (RHCs), Community Mental Health Centers (CMHCs), Safety Net Hospitals, Family Planning, and STI Providers - Specialty Plan requires trauma-informed care and coordination with state agencies - Key Requirements: - Provider network adequacy and access standards - Value-based purchasing and member incentive programs - Compliance with federal and state regulations, including HIPAA - Key personnel qualifications and ongoing performance reporting - Pricing and Contract Structure: - Capitated payment model by region and eligibility group - One-year base contract with up to four one-year renewal options - No specific OEMs or vendors are named; opportunity is open to qualified managed care organizations

Description

This solicitation is a Request for Proposal (RFP) issued on behalf of the Department of Social Services for the MO HealthNet Managed Care Program. The procurement involves managed care services for various eligible groups under the MO HealthNet program, including families, children, pregnant women, foster care, and adult expansion groups across multiple regions in Missouri. The contract period is for one year starting from the effective date of the contract. Proposals must be submitted electronically through MissouriBUYS by September 2, 2026.

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