Long Term Services & Supports Eligibility and Quality Review

The Michigan Department of Health and Human Services (MDHHS) is issuing a Request for Proposal (RFP) for Statewide Medicaid Long Term Services and Supports Eligibility and Quality Reviews. The contract will cover Long Term Care (LTC) programs in the jurisdictions of Ingham County and the City of Lansing, including Nursing Facilities, the MI Choice Waiver Program, the Program for All Inclusive Care for the Elderly (PACE), and MI Health Link. The selected contractor will be required to perform timely verification reviews of Level of Care Determination (LOCD) assessments, conduct secondary reviews, participate in the State Fair Hearing process, and complete expanded home help services and quality reviews. The contractor must meet strict service level agreements, submit periodic reports, and may be subject to liquidated damages for non-compliance. The contract term is for an initial period with renewal options, and pricing is expected to be firm for the entire contract length. The proposal deadline is May 2, 2024, and the anticipated contract start date is October 3, 2024, with services beginning on January 1, 2025.

The RFP does not specify any set-aside designations or restrictions on the types of organizations that can respond. No information is provided about any incumbent contractors or the current funding sources and requirements for this contract. The RFP indicates the state reserves the right to award multiple, optional-use contracts or awards by contract activity, but does not provide any estimated award values or budget ranges.