Claritev.docx

This is a Pre-Proposal Network Opportunities Form submission filed by Claritev for the Indiana Family and Social Services Administration's Office of Medicaid Policy and Planning (OMPP) Request for Proposal 27-88343 regarding Indiana Medicaid Managed Care Organizations. The RFP solicits proposals from Managed Care Organizations (MCOs) to provide statewide risk-based Medicaid services across four programs—Hoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and Indiana PathWays for Aging—collectively serving approximately 1.5 million Hoosiers. The form was submitted by Morgan Kinnick, AVP Public Sector Growth, with contact information for Claritev located in McLean, Virginia. Written questions are due September 11, 2026, with a pre-proposal conference scheduled for September 10, 2026, and proposals due November 6, 2026. The contract term is four years with two optional one-year renewals available at the state's discretion, for a potential total of six years.

Respondents must demonstrate current MCO service in at least one state and at least five years of prior MCO experience, with contractors required to be Indiana-licensed health maintenance organizations achieving NCQA accreditation by contract start. Administrative offices must be located within five miles of the Indiana Government Center in Indianapolis. The total estimated base capitation across all programs exceeds $4.9 billion for the initial rating period, with specific PMPM rates established for each program: Hoosier Healthwise (approximately 589,000 beneficiaries at $305.42 for-profit/$304.23 not-for-profit), Healthy Indiana Plan (approximately 487,000 beneficiaries at $228.72 to $1,936.56 PMPM), Hoosier Care Connect (approximately 80,000 beneficiaries at $1,448.47 PMPM), and PathWays for Aging (approximately 115,000 seniors at $3,468.29 PMPM). Evaluation criteria total 90 points with a mandatory Buy Indiana Initiative preference offering 5 points and an Indiana Veteran Owned Small Business subcontracting goal offering 5 points plus 1 bonus point. Contractors must maintain minimum Risk Based Capital ratios of 300 percent and obtain fidelity bond, professional liability insurance, and commercial reinsurance with attachment points not exceeding $2 million and co-insurance capped at 20 percent.