Heatlh Choice Illinois (HCI)-Molina

The State of Illinois Department of Healthcare and Family Services (HFS) has awarded a managed care services contract to Molina Healthcare of Illinois under the Health Choice Illinois (HCI) program. This is a competitively selected managed care organization contract involving capitated managed care services for Medicaid beneficiaries, with payment structured on a per-member-per-month (PMPM) risk-based capitation basis in accordance with 42 Code of Federal Regulations Part 438. The contract encompasses comprehensive managed health care services including medical, behavioral health, and long-term care services. The contract period runs from July 15, 2026, through December 31, 2030, with a stated contract value of $9,999,999,999.00 (approximately $10 billion).

Molina Healthcare of Illinois is one of five managed care organizations selected under Option A of the broader HCI award, which collectively carries a combined value of $362.39 billion across the initial and renewal terms of the statewide program. As a selected vendor, Molina Healthcare of Illinois is required to meet Business Enterprise Program utilization goals with a 1 percent Certified Business Enterprise (BEP) participation target and must comply with the State of Illinois diversity and inclusion requirements established by the Commission on Equity and Inclusion. The actual award amount to Molina will be determined based on Illinois Department HFS-approved capitation rates and member enrollment numbers across the state.