AHCA RFI 014-2223 Dental Program (2).pdf

AHCA RFI 014-22/23

STATE OF FLORIDA

AGENCY FOR HEALTH CARE ADMINISTRATION

REQUEST FOR INFORMATION

PROCUREMENT OF THE

STATEWIDE MEDICAID PREPAID DENTAL PROGRAM

A. REQUEST FOR INFORMATION (RFI)

In December 2018, the Agency for Health Care Administration (Agency) implemented a statewide Medicaid prepaid dental program. Pursuant to Chapter 2016-109, Laws of Florida, the Florida Medicaid program awarded five-year contracts in 2017. Chapter 2020-156, Laws of Florida, required the Agency, beginning in 2023, to re-procure six-year contracts with dental plans. These six-year contracts will take effect in 2024.

Currently, three plans, operating statewide comprise Florida’s Medicaid prepaid dental program.

These plans serve 4.8 million Floridians. They provide comprehensive dental care to children, including all medically necessary dental services, through sixteen State Plan services. Adults receive emergency treatment through State Plan services, and preventative, diagnostic, restorative, and periodontal care through the richest adult dental benefit package ever offered by Florida Medicaid.

The Agency is seeking information from entities with direct experience in the provision of dental services through a prepaid arrangement and other entities with knowledge about best practices and innovations in business models and service delivery for dental services. The Agency will consider information gathered from Responses to this RFI in preparing the competitive procurement for the Statewide Prepaid Dental program which is scheduled for release in Summer 2023.

The Agency is interested in innovative ideas and best practices that:

• Utilize value-based payment (VBP) designs to simultaneously increase quality and reduce costs.

• Improve integration of dental and primary care services for children, adolescents, pregnant women, and the elderly.

• Improve integration of dental and primary care services for iBudget enrollees.

• Improve understanding of the unique oral health needs for individuals with intellectual and developmental disabilities

• Identify different options for integrating sedation dentistry into dental services for individuals with intellectual and developmental disabilities, including iBudget enrollees.

• Identify certification(s) and accreditation(s) appropriate for dental health insurance plans which allow the safe and high-quality provision of dental care, including individuals with intellectual and developmental disabilities.

• Identify certification(s) and accreditation(s) appropriate for dental providers, including dentists, dental assistants, and dental hygienists, which allow for the safe and high-quality provision of dental care, including individuals with intellectual and developmental disabilities.

• Educate future dentists in an academic setting about providing dental services for individuals with intellectual and developmental disabilities.

• Provide enhanced orthodontia services.

• Improve integration of dental and sedation services for children, adolescents, pregnant women, and the elderly.

• Leverage community partnership innovations to improve access to dental services and outcomes for Medicaid recipients.

• Determine the value of our current quality measures and verify other quality measures that might be utilized.

• Implement robust Healthy Behaviors incentive programs.

• Describe innovative delivery methods for the dental care model, including care bundling, that empower recipients in making more informed health care decisions.

• Describe assessment and needs for rural regions and counties. What relationships can be leveraged to serve the needs of rural populations?

• Improve providers’ experience with the SMMC Dental Program.

• Improve recipients’ experience with the SMMC Dental Program.

• Achieve cost savings throughout the SMMC Dental Program.

Responses should include, but are not limited to, information to address the following components:

• Operational strategies.

• Performance metrics – including use of digital measures and electronic clinical data sources.

• Provider network requirements.

• Best practices for maximizing communication and resources.

• Integration with the Agency’s Florida Health Care Connections (FX) Project and the Federal Centers for Medicare and Medicaid Services Interoperability Rule.

Respondents who reply to this RFI may be invited to present their ideas in person to Agency leadership. An invitation to present in person does not prohibit an entity from responding to any related subsequent solicitation.

A RFI is not a method of procurement. Responses to an RFI are not offers and will not be accepted by the Agency to form a binding contract. This RFI shall not directly result in the execution of a contract with the Agency. The Agency reserves the right to utilize the information gathered through the RFI process to develop a scope of services, which may be incorporated into a contract using a statutorily approved method of procurement.

B. RFI RESPONSE REQUIREMENTS

Respondents to this RFI are asked to be thorough, but concise. The RFI Response must include the following:

a. The Respondent’s name, place of business address(s), contact information, including representative name and alternative, if available, telephone number(s), and e-mail address(s);

b. A description of how the Respondent’s approach will offer advantages or improvements ensuring continued improvement in overall Medicaid program quality with regards to the provision of dental services and will further the Agency’s goal to reduce potentially preventable dental inpatient and outpatient hospital events, and unnecessary use of ancillary services. The description should also identify known or potential concerns with the approach.

C. RFI PROPRIETARY INFORMATION

Any portion of the submitted Response which is asserted to be exempt from disclosure under

Chapter 119, Florida Statutes, shall be clearly marked “exempt”, “confidential”, or “trade secret” (as applicable) and shall also contain the statutory basis for such claim on every page. Pages containing trade secrets shall be marked “trade secret as defined in Section 812.081, Florida Statutes”. Failure to segregate and identify such portions shall constitute a waiver of any claimed exemption and the

Agency will provide such records in response to public records requests without notifying the respondent. Designating material simply as “proprietary” will not necessarily protect it from disclosure under Chapter 119, Florida Statutes. An entire Response should not be considered trade secret.

D. RFI RESPONSE SUBMISSION

Respondents to this RFI shall submit one (1) electronic copy of its Response. The Response shall not exceed forty (40), single-sided, pages in length. The electronic format shall be submitted via e-mail.

The software used to produce the electronic files must be Microsoft Word 2019 and/or Excel 2019 or newer. The electronic files must be logically named.

The Respondent shall also submit via e-mail one (1) electronic redacted copy of the Response suitable for release to the public. Any confidential or trade secret information covered under

Section 812.081, Florida Statutes, should be either redacted or completely removed. The redacted

Response shall be marked as the “redacted” copy and contain a transmittal letter authorizing release of the redacted version of the Response in the event the Agency receives a public records request.

Responses to this RFI shall be provided no later than 5:00 PM, Eastern Standard Time, May 30, 2023. Responses shall be e-mailed to solicitation.questions@ahca.myflorida.com.

Trey Collins

Chief, Purchasing and Contract Administration solicitation.questions@ahca.myflorida.com

After the Agency has received all Responses to this RFI, the Agency, in its sole discretion, shall determine if a meeting with Respondents is necessary to clarify the information received. In the event that the Agency decides to hold a meeting, the Respondent (s) will be notified via email.

E. RFI VENDOR COSTS

mailto:solicitation.questions@ahca.myflorida.com mailto:solicitation.questions@ahca.myflorida.com

Respondents are responsible for all costs associated with preparing a Response to this RFI. The

State of Florida, Agency for Health Care Administration, will not be responsible for any Respondent costs associated with preparing a Response to this RFI.

F. AGENCY FOR HEALTH CARE ADMINISTRATION WEBSITE

Additional information about the Florida Agency for Health Care Administration can be found on the Agency’s website at: http://ahca.myflorida.com/