Easterseals Community Network.docx

This is a Pre-Proposal Network Opportunities Form submission for Request for Proposal 27-88343, issued by the Indiana Family and Social Services Administration's Office of Medicaid Policy and Planning, seeking managed care organizations to provide statewide Medicaid services. The RFP solicits proposals from MCOs to serve approximately 1.5 million Hoosiers across four programs: Hoosier Healthwise, Healthy Indiana Plan, Hoosier Care Connect, and Indiana PathWays for Aging. Respondents must submit the optional Pre-Proposal Network Opportunities Form by September 10, 2026, at 1:30 PM Eastern Time via email to rfp@idoa.in.gov. A pre-proposal conference is scheduled for September 10, 2026, with written questions due September 11, 2026, and responses provided by October 2, 2026. A second round of written questions closes October 9, 2026, with responses by October 23, 2026. Proposal discussions, oral presentations, and Best and Final Offers are anticipated in May 2027, with Award Recommendation expected in July 2027. 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 administrative offices located within five miles of the Indiana Government Center in Indianapolis. Contractors must be Indiana-licensed health maintenance organizations achieving NCQA accreditation by contract start or no later than the end of the second full calendar year of operation. For PathWays for Aging services, contractors must obtain NCQA accreditation including the LTSS Distinction and execute a State Medicaid Agency Contract to operate a Dual Eligible SNP effective January 1, 2029. The total estimated base capitation across all programs exceeds $4.9 billion for the initial rating period, with state fiscal year 2027 capitation rates ranging from $228.72 to $3,468.29 PMPM depending on the program. A mandatory Buy Indiana Initiative preference offering 5 points and an Indiana Veteran Owned Small Business subcontracting goal of 3 percent (5 points plus 1 bonus point available) apply. Contractors must maintain minimum Risk Based Capital ratios of 300 percent per NAIC standards, obtain fidelity bond and professional liability insurance, and purchase commercial reinsurance with attachment points not exceeding $2 million and co-insurance responsibility capped at 20 percent. Compliance performance is tied to a pay-for-outcomes program withholding 1.85-2.25 percent of capitation payments annually from 2029-2034, with estimated recovery of 60-70 percent based on performance against HEDIS and outcome measures.