April 4, 2013

Twenty-Seven Bids Submitted for Medicaid Managed Care Program

Twenty-seven health plans submitted bids to the Agency for Health Care Administration (AHCA) on March 29 to serve all 11 regions under the Statewide Medicaid Managed Care Program. Health plans that submitted bids in each region were Coventry Health Care of Florida, Humana Medical Plan, Simply Healthcare Plans dba Clear Health Alliance HIV/AIDS Specialty Plan, Sunshine State Health Plan, United Healthcare of Florida and Wellcare of Florida. The full list of plan submissions by region is available online.

As part of the evaluation process, providers have an opportunity to comment on the plans that submitted bids via an online survey. Comments must be submitted by April 17, 2013, at 5 p.m. EDT. AHCA will consider only one comment from each distinct provider and comments will only be accepted on health plans submitting bids for the region in which the provider is located. Some of the factors being considered in the selection of plans are:

    • Accreditation by a nationally recognized accrediting body
    • Experience serving similar populations, including the organization's record in achieving specific quality standards with similar populations
    • Availability and accessibility of primary care and specialty physicians in the provider network
    • Establishment of community partnerships with providers that create opportunities for reinvestment in community-based services
    • Organization commitment to quality improvement and documentation of achievements in specific quality improvement projects, including active involvement by organization leadership
    • Provision of additional benefits, particularly dental care and disease management, and other initiatives that improve health outcomes
    • Evidence that a plan has written agreements or signed contracts or has made substantial progress in establishing relationships with providers before the plan submits a response
    • Comments submitted in writing by any enrolled Medicaid provider relating to a plan participating in the procurement in the same region as the submitting provider
    • Documentation of policies and procedures for preventing fraud and abuse
    • The business relationship an eligible plan has with any other eligible plan that responds to the invitation to negotiate

It is anticipated that the plans will be selected in late June and the contract would be awarded by Sept. 16, 2013, with the contracts signed by Jan. 1, 2014.