On Aug. 25, the Department of Health Care Services (DHCS) has announced its intent to award contracts to commercial managed care plans to deliver Medi-Cal services beginning in 2024.
On Feb. 9, DHCS released a request for proposal (RFP) available to commercial managed care plans interested in contracting to serve Medi-Cal patients. Through this RFP process and restructuring the current contracts between the state and all its contracted Medi-Cal managed care plans, the state is seeking to enhance how care is delivered to Medi-Cal members by advancing health equity, quality, access, accountability, and transparency of the health care delivery system.
Interested plans were required to submit their proposals in early April, and DHCS has spent the past four months scoring those submissions. The prospective winners of the procurement are:
Along with this announcement, DHCS also released a crosswalk of the current plans operating in each county and what the proposed new plans will be, including those counties with a direct Kaiser Permanente contract, along with projected enrollment. Counties not listed in this crosswalk are not expected to have any changes in health plans serving their county in 2024. The state also released frequently asked questions.
Proposers with unsuccessful bids had the opportunity to file an appeal for any of the intended contract award(s). Those seeking to appeal were required to file a notice of intent to appeal with DHCS by Sept. 1. On Sept. 2, DHCS announced which of the intended contract awards received a notice of intent to appeal and from which health plans. Within five calendar days after filing a notice of intent to appeal, they had to submit their full and complete written appeal statement identifying the specific grounds for the appeal. DHCS will not make an award in a specific county until all appeals against the award for that county are withdrawn by the appellant(s), denied, or resolved to DHCS’ satisfaction.
CHA will continue to monitor and communicate updates on the RFP process and subsequent information related to operational readiness requirements.