January 08, 2014 RFP for Dental Benefit Management Program

Baton Rouge, Louisiana, Jan 08, 2014 - 1. Louisiana intends to transition to provision of dental services for Medicaid and CHIP state plan services through procurement of a Prepaid Ambulatory Health Plan (PAHP). The contract will require education/outreach to dentists, dental hygienists, and the state dental association. Proposers plans for education and outreach will be considered when scoring proposal.
2. The purpose of this RFP is to solicit proposals from qualified proposers to manage the Medicaid Dental Benefit Program for all eligible Medicaid recipients, utilizing the most cost-effective manner and in accordance with the terms and conditions set forth herein.
3. The Contractor who is awarded this contract should be prepared to deliver services to a population of approximately one million full benefit Medicaid enrollees. A contract is necessary to achieve the following goals:
A. improved coordination of care;
B. better dental health outcomes;
C. increased quality of dental care;
D. improved access to essential specialty dental services;
E. outreach and education to promote dental health;
F. increased personal responsibility and self-management;
G. a more financially sustainable system; and
H. net savings to the state compared to the existing FFS Medicaid delivery system
4. This RFP solicits proposals, details proposal requirements, defines DHH’s minimum service requirements, and outlines the state’s process for evaluating proposals and selecting the DBPM.
5. Federal Authority for LDH to procure the DBPM is contained in Section 1932(a) (1)(A) of the Social Security Act as Amended and 42 CFR, Part 438; as those requirements apply to PAHPs. LDH intends to submit a State Plan Amendment to utilize a DBPM.