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Details:
- Medicaid
Keywords: RFP 3000017417, Managed Care 3.0, UnitedHealthcare Community Plan, UHC
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Details:
- Medicaid
- Managed Care
RFP #, DBPM 3.0 (1/1/2021 - present) DentaQuest (DQ) and Managed Care of North America (MCNA)
Downloadable Assets:
DQ Contract DQ Amd 1 DQ Amd 2 DQ Amd 3 DQ Amd 4 DQ Amd 5 DQ Amd 6 DQ Amd 7 DQ Amd 8 DQ Amd 9 DQ Amd 10 DQ Amd 11 DQ Amd 12 DQ Amd 13 DQ Amd 14 MCNA Contract MCNA Amd 1 MCNA Amd 2 MCNA Amd 3 MCNA Amd 4 MCNA Amd 5 MCNA Amd 6 MCNA Amd 7 MCNA Amd 8 MCNA Amd 9 MCNA Amd 10 MCNA Amd 11 MCNA Amd 12 MCNA Amd 13 DQ Amd 15 MCNA Amd 14 MCNA Amend 15 -
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- Medicaid
- Managed Care
Keywords: RFP 3000017417, Managed Care 3.0, Aetna Better Health, ABH, Healthy Blue, HBL, AmeriHealth Caritas, ACLA, Louisiana Healthcare Connections, LHCC, UnitedHealthcare Community Plan, UHC, Humana Healthy Horizons, HHH
Downloadable Assets:
ABH Original ABH Amd 1 ABH Amd 2 ABH Amd 3 ABH Amd 4 ABH Amd 5 ABH Amd 6 ABH Amd 7 ABH Amd 8 ABH Amd 9 ABH Amd 10 ABH Amd 11 ABH Amd 12 ACLA Original Contract ACLA Amd 1 ACLA Amd 2 ACLA Amd 3 ACLA Amd 4 ACLA Amd 5 ACLA Amd 6 ACLA Amd 7 ACLA Amd 8 ACLA Amd 9 ACLA Amd 10 ACLA Amd 11 ACLA Amd 12 HBL Original Contract HBL Amd 1 HBL Amd 2 HBL Amd 3 HBL Amd 4 HBL Amd 5 HBL Amd 6 HBL Amd 7 HBL Amd 8 HBL Amd 9 HBL Amd 10 HBL Amd 11 HBL Amd 12 HHH Original Contract HHH Amd 1 HHH Amd 2 HHH Amd 3 HHH Amd 4 HHH Amd 5 HHH Amd 6 HHH Amd 7 HHH Amd 8 HHH Amd 9 HHH Amd 10 HHH Amd 11 HHH Amd 12 LHCC Original Contract LHCC Amd 1 LHCC Amd 2 LHCC Amd 3 LHCC Amd 4 LHCC Amd 4 LHCC Amd 5 LHCC Amd 6 LHCC Amd 7 LHCC Amd 9 LHCC Amd 10 LHCC Amd 11 LHCC Amd 12 Att A: Model Contract -
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- Medicaid
- Managed Care
- Pharmacy
During the summer of 2021, as part of its review of the current transportation and pharmacy benefit manager models, the Department sought input from the public about the key factors that must be considered when improving the models. Keywords: NEMT, PBM, Transportation, Pharmacy
Downloadable Assets:
360 Trucking NEMT Albertsons Companies Alisha Brogan Allen Council on Aging Allen Council on Aging/Allen Parish Transit AmeriHealth Caritas Louisiana, Inc. d/b/a AmeriHealth Caritas Louisiana Andrea's Medical Transportation Angela Hoover, Walgreens Anitra Covington, Covington Transportation Assisted Transportation Group LLC Bellingrath Pharmacy Bergeron Mobile Health Services Inc Brownsville Transportation LLC Central Louisiana Medical Transportation, LLC Diversity Travels Drennan's Pharmacy Eagle Transit, LLC East Feliciana COA En Route Transportation Services Essential Care Services Evangeline Council on Aging Fairview Treatment Center Get Well Medical Transportation Glynda Bradley Habakkuk Transportation Service LLC Hattie Lawton Hoard Medical Holly Molina Humana Pharmacy Solutions, Inc. James Campbell Karen Scallan, Special Needs and Parent Support Services of LA, LLC Kim Wixson RPH, Cottonport Corner Drug Lea Gray-Winfrey/ EXCELth, Inc. Leah Snyder Len Transportation Libra Transportation LLC Louisiana Community Pharmacy Enhanced Service Network Louisiana Healthcare Connections Louisiana Independent Pharmacies Association M&M Taxi, LLC Mark Declouet Markita Washington Matte's Pharmacy Inc Matt Fontenot Meditrans, LLC Mjsc Professional Services LLC ModivCare Solutions, LLC Monica Stampley Morris & Dickson MTK Transportation Services My 3bees Transportation Natalie Simmons National Association of Chain Drug Stores (NACDS) Northside Pharmacy Odyssey House Louisiana, in partnership with Charbonnet Pharmacy OneBunchHookUp, LLC One Call Government Solutions, LLC Pamela Delatte Patio Drugs Pointe Coupee Council on Aging Pointe Coupee Council on Aging (Becky Bergeron) Preventive Measures Transportation Services R & R Transportation LLC Ready Non-Emergency Medical Transportation Resilient Transportation L3C Ricky T Guidry Ride to Better Health LLC Ritas Transportation Service, LLC Rep. Rodney Lyons Ryan Kuehn Sabine Council on Aging, Inc. Sabrina Smith Safe Hands Transportation Self SMILE Community Action Agency Southeastrans Stakeholder Star Clipper Transfers, LLC T&R Citywide Transportation Tcl Medical Transportation, LLC Tender Kare Transport Tony Mollica on behalf of Humana Health Benefit Plan of Louisiana, Inc Tori Rouyer Transit Express, LLC Transportation United Health Group Veyo VitalRx of Louisiana Wolfes Pharmacy Inc -
Details:
- Medicaid
Fee-for-Service Transportation Broker Executed Contract
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Details:
- Medicaid
Fee-for-Service Transportation Broker Executed Contract
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Details:
- Medicaid
- Managed Care
- Pharmacy
Keywords: RFP #:3000018331
Downloadable Assets:
Original RFP Document Addendum 1 - Schedule of Events Addendum 2 - Schedule of Events Revised Addendum 3 - Schedule of Events Revised Addendum 4 - Questions and Answers Addendum 5 - CF-1 MCO Manual - Procurement Library MCO Model Contract - Procurement Library Batch Pharmacy Encounter System Companion Guide - Procurement Library MCO Quality Companion Guide - Procurement Library MCO System Companion Guide - Procurement Library Financial Reporting Guide - Procurement Library Marketing and Member Education Guide - Procurement Library Medicaid 834 Benefit and Enrollment Transaction Set Companion Guide - Procurement Library State Fair Hearing Companion Guide - Procurement Library Rx054-PBM Report - Procurement Library Rx055-Pharmacy Report - Procurement Library Rx162-Drug Utilization Review Report - Procurement Library Rx165-Lock-In Report - Procurement Library Rx175-Hep C Report - Procurement Library Rx178-BH and SUD - Procurement Library MCO Historical Table - Procurement Library Q&A Submission Template - Procurement Library Hudson and Veterans Initiative Response Template - Procurement Library Criminal History Records Check of Applicants and Employees - Procurement Library CMS Interoperability and Patient Access Rule - Procurement Library PDL - Procurement Library - Procurement Library Diagnosis Code Chart - Procurement Library State plan reimbursement pages - Procurement Library Medicaid Managed Care Transparency Report - Procurement Library Drug Utilization Review Program Health Plan Advisory - Procurement Library LDH Medicaid POS User Guide - Procurement Library MCO Data - Procurement Library OTS Enterprise Architecture and System Development Requirements - Procurement Library CVS Health - Redacted Technical Proposal Magellan Medicaid Administration, Inc - Redacted Technical Proposal MedImpact Healthcare Systems, Inc - Redacted Technical Proposal -
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- Medicaid
- Managed Care
At the end of 2020, LDH requested input on key elements of the Medicaid managed care contracts. This included feedback on the following areas: Behavioral health integration Child and maternal health outcome improvement Delivery system reform Disaster planning and recovery Department of Justice settlement agreement requirements Fraud, waste, and abuse initiatives Health equity Increased MCO accountability Keywords: Managed Care 3.0, Aetna Better Health, ABH, AmeriHealth Caritas, ACLA, Healthy Blue, HBL, Louisiana Healthcare Connections, LHCC, UnitedHealthcare Community Plan, (UHC)
Downloadable Assets:
Aetna Better Health Feedback AmeriHealth Caritas Louisiana Baton Rouge Neonatal Associates, Inc. - Infamedics Behavioral Health Group Center for Hope Children and Family Services, LLC Coalition of Louisiana Addiction Service & Prevention Providers (CLASPP) Community Pharmacists' Impact on Healthcare Spending Community Pharmacy Care Management Easterseals Louisiana Franciscan Missionaries of Our Lady Health System Gina Lindsey - Behavioral Health Provider Green and Healthy Homes Initiative Greenpath International Inc Healthy Blue HousingLOUISIANA Housing NOLA Humana Health Benefit Plan of Louisiana, Inc. Iberia Pediatrics Integrated Community Pharmacy Medication Use Support Services Louisiana Addiction Treatment Providers (LATP) Louisiana Center for Health Equity Louisiana Chapter of the American Academy of Pediatrics Louisiana Commission on Perinatal Care and Prevention of Infant Mortality Louisiana Community Pharmacy Enhanced Services Network Louisiana Independent Pharmacies Association Louisiana Partnership for Children and Families Louisiana Psychiatric Medicine Association Louisiana Public Health Institute & Partnership for Achieving Total Health Louisiana Rural Mental Health Alliance Louisiana State Medical Society Maternal Fetal Medicine MD Merakey Pennsylvania Odyssey House Louisiana (OHL) Office of Public Health-Bureau of Family Health (OPH-BFH) Unite Us UnitedHealthcare Community Plan of Louisiana Volunteers of America Southeast Louisiana -
Details:
- Medicaid
- Managed Care
Request for Proposals (RFP) for Managed Care Single Transportation Broker and Fee-for-Service Transportation Broker MediTrans, One Bunch, Southeastrans, Veyo, We Lift
Downloadable Assets:
Single Transportation Broker RFP MediTrans Proposal Response - Technical Business Proposal (Redacted) MediTrans Proposal Response - Hudson and Veteran Initiative Response One Bunch Proposal Response Southeastrans Proposal Response - Business and Technical Proposal (Redacted) Southeastrans Proposal Response - Proposal Coversheet and Addenda Southeastrans Proposal Response - Appendix A Southeastrans Proposal Response - Appendix B (Redacted) Southeastrans Proposal Response - Appendix B (Redacted) Southeastrans Proposal Response - Appendix C Southeastrans Proposal Response - Appendix D Southeastrans Proposal Response - Appendix E (Redacted) Southeastrans Proposal Response - Appendix F (Redacted) Southeastrans Proposal Response - Appendix G Veyo Proposal Response - Technical and Business Proposal (Redacted) Veyo Proposal Response - 2017 and 2018 Audited Financial Statements (Redacted) Veyo Proposal Response - 2019 and 2020 Audited Financial Statements (Redacted) We Lift Proposal Response - Business Proposal We Lift Proposal Response - Cost Proposal We Lift Proposal Response - Cover Letter We Lift Proposal Response - Table of Contents We Lift Proposal Response - Technical Proposal Single Transportation Broker RFP Technical Evaluation Attachment A, Certification Statement - Procurement Library Attachment B, Proposal Compliance Matrix - Procurement Library Attachment C, Electronic Vendor Payment Solution - Procurement Library Hudson and Veterans Initiative Response Template - Procurement Library Louisiana Medicaid Transportation Broker RFP Data Use Agreement - Procurement Library Louisiana Medicaid 837 Health Care Claim Companion Guides - NEAT - - Procurement Library Louisiana Medicaid 837 Health Care Claim Companion Guides - NEMT (non-ambulance) - Procurement Library Louisiana Medicaid HIPAA 5010A General Companion Guide - Procurement Library MCO Manual - Procurement Library MCO System Companion Guide - Procurement Library Medicaid Services Manual (Medical Transportation chapter) - Procurement Library Fee for Service Call Center Metrics - Procurement Library Managed Care Organization Call Center Metrics - Procurement Library Addendum 1 - Schedule of Events - Procurement Library Addendum 2 - Schedule of Events - Procurement Library Addendum 3 - Propose Inquiries - Procurement Library -
Details:
- Medicaid
- Managed Care
The Louisiana Department of Health (LDH) Medicaid issued a Request for Proposals (RFP) for qualified Managed Care Organizations (MCO) to provide high quality healthcare services statewide to enrollees in the Louisiana Medicaid Managed Care Program, a full risk-bearing health care delivery system. Due to the size, impact and importance of of this RFP, LDH conducted a second scoring session with a new independent team to confirm results. Keywords: Managed Care 3.0, RFP 3000017417, Aetna Better Health, ABH, Healthy Blue, HBL, AmeriHealth Caritas, ACLA, Louisiana Healthcare Connections, LHCC, UnitedHealthcare Community Plan, UHC, Humana Healthy Horizons, HHH
Downloadable Assets:
Request for Proposals (RFP) RFP Attachment C: MCO Covered Services RFP Attachment E: APM Strategic Plan Requirements and Reporting Template RFP Attachment F: Provider Network Standards RFP Attachment G: Table of Monetary Penalties RFP Attachment H: Quality Performance Measures RFP Attachment I: LDH Standard Contract Form (CF-1) RFP Exhibit A: Certification Statement RFP Exhibit B: Material Subcontractor Response Template RFP Exhibit C: Proposal Compliance Matrix RFP Exhibit D: Medicaid Ownership and Disclosure Form RFP Addendum 4: Proposer Inquiries RFP Addendum 5: Schedule of Events Aetna Better Health - Proposal Aetna Better Health - Proposal - Appendix A - Exhibit B: Material Subcontractor Response Template Aetna Better Health - Proposal - Appendix B - Audited Financial Statements Aetna Better Health - Proposal - Appendix C - Exhibit D: Ownership and Disclosure Form Aetna Better Health - Proposal - Quality Response Template NCQA Ratings Aetna Better Health - Proposal - Hudson and Veterans Initiative Response Template AmeriHealth Caritas - Proposal Healthy Blue - Proposal Humana - Proposal Louisiana Healthcare Connections - Proposal UnitedHealthcare Community Plan - Proposal Aetna Better Health - Letter to Proposer AmeriHealth Caritas - Letter to Proposer Healthy Blue - Letter to Proposer Humana - Letter to Proposer Louisiana Healthcare Connections - Letter to Proposer UnitedHealthcare Community Plan - Letter to Proposer Evaluation Documents - Summary Scoresheet - First Team Evaluation Documents - Summary Scoresheet - Second Team Hudson and Veterans Initiative Response Template - Procurement Library Louisiana Medicaid MCO RFP Data Use Agreement - Procurement Library Quality Response Template - Procurement Library Question and Answer Submission Template - Procurement Library Healthy Louisiana Data Book - Procurement Library Healthy Louisiana Data Book Exhibits - Procurement Library Louisiana Medicaid Preferred Language Statewide - Procurement Library OPH Population Health Resources - Procurement Library Potential Enrollment - Procurement Library Chisholm Compliance Guide - Procurement Library DOJ Agreement Compliance Guide - Procurement Library Financial Reporting Guide - Procurement Library Justice-Involved Pre-Release Enrollment Program Manual - Procurement Library Marketing and Member Education Companion Guide - Procurement Library MCO Manual - Procurement Library MCO Quality Companion Guide - Procurement Library MCO System Companion Guide - Procurement Library Batch Pharmacy Encounter System Companion Guide - Procurement Library Medicaid 834 Benefit and Enrollment Transaction Set Companion Guide - Procurement Library State Fair Hearing Companion Guide - Procurement Library Criminal History Records Check of Applicants and Employees - Procurement Library CMS Interoperability and Patient Access Rule - Procurement Library Geo Access Mapping 3.0 (#348) - Geo Access Mapping Attestation Form Geo Access Mapping 3.0 (#348) - Geo Access Mapping Reporting Template Financial Reporting Requirements - Agreed Upon Procedures -
Details:
- Medicaid
Keywords: HCBS, Procurement, RFP, Home and Community Based Services
Downloadable Assets:
RFP Document RFP Addendum 1 - Schedule of Events RFP Addendum 2 - Notification of Protest RFP Addendum 3 - Revised Schedule of Events RFP Addendum 4 - Lift of Stay RFP Addendum 5 - Revised Schedule of Events RFP Addendum 6 - Revised Schedule of Events RFP Addendum 7 - Revised Schedule of Events RFP Attachment G Revised 6.21.2021 RFP Addendum 8 - Written Q & A RFP Exhibit 36 - Major Record Data Counts RFP Exhibit 37 - Path to Employment Questions RFP Exhibit 38 - Data from Current HCBS EVV System RFP Exhibit 39 - OCDD Plan of Care Documents RFP Exhibit 40 - EVV Policy RFP Exhibit 41 - HHCS Record and Data Counts 8.26.21 RFP Addendum 9 - Revised Schedule of Events RFP Addendum 10 - Additional Written Q&A RFP Exhibit 42 - Sample Mailings Required by Contractor Updated 10.12.21 RFP Addendum 11 - Administrative Error Procurement Library - TMSIS Data Elements (OAAS-OCDD) Procurement Library - EPSDT Comprehensive Plan of Care Procurement Library - EPSDT Data Fields Procurement Library - CMS EVV Outcomes Based Certification Criteria Procurement Library - New Opportunities Waiver Flexing Units Procurement Library - OCDD Sharing Across Waivers Detail Procurement Library - Adult Day Health Care Fact Sheet Procurement Library - Adult Day Health Care Fee Schedule Procurement Library - Adult Day Health Care Provider Manual Procurement Library - Adult Day Health Care Waiver Application Procurement Library - Children's Choice Fact Sheet Procurement Library - Children's Choice Fee Schedule Procurement Library - Children's Choice Waiver Application Procurement Library - Children's Choice Waiver Provider Manual Procurement Library - Community Choices Waiver Application Procurement Library - Community Choices Waiver Fact Sheet Procurement Library - Community Choices Waiver Fee Schedule Procurement Library - Community Choices Waiver Provider Manual Procurement Library - EPSDT Support Coordination Handbook Procurement Library - Long Term Personal Care Services and EPSDT Provider Manual Procurement Library - Long Term Personal Care Services Fact Sheet Procurement Library - Long Term Personal Care Services Fee Schedule Procurement Library - New Opportunities Waiver Application Procurement Library - New Opportunities Waiver Fact Sheet Procurement Library - New Opportunities Waiver Fee Schedule Procurement Library - New Opportunities Waiver Provider Manual Procurement Library - Residential Options Waiver Application Procurement Library - Residential Options Waiver Fact Sheet Procurement Library - Residential Options Waiver Fee Schedule Procurement Library - Residential Options Waiver Provider Manual Procurement Library - Supports Waiver Application Procurement Library - Supports Waiver Fact Sheet Procurement Library - Supports Waiver Fee Schedule Procurement Library - Supports Waiver Provider Manual -
Details:
- Medicaid
Fee-for-Service Transportation Broker Executed Contract
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