P029724D.pdf Summary

This is a Request for Proposals (RFP) issued by the State of New Jersey, Department of Human Services, Division of Medical Assistance and Health Services (DMAHS) for managed long-term care services. The RFP seeks proposals for the operation and administration of a managed long-term care program serving Medicaid-eligible individuals requiring institutional or community-based long-term care services. The scope includes care coordination, utilization management, network development, and claims processing. Proposals must be submitted by the specified due date, with contract award anticipated within 180 days of the proposal deadline. The contract term is expected to be five years from the effective date, with options to renew for up to two additional one-year periods at the State's discretion. A pre-proposal conference is scheduled to allow bidders to clarify requirements and submit questions regarding the scope of work.

The RFP anticipates multiple contract awards with pricing based on a capitated monthly rate per eligible member across different service categories and geographic regions within New Jersey. Incumbents currently operating managed long-term care programs under existing State contracts are eligible to compete. The procurement is open to qualified health plans, managed care organizations, and other licensed entities meeting New Jersey regulatory requirements. Funding is derived from the State Medicaid program and federal matching funds. Bidders must demonstrate financial stability, appropriate licensing, and capacity to serve the target populations, including elderly individuals and those with disabilities requiring long-term care services.