Prepaid Inpatient Health Plan (PIHP) RFP

The Michigan Department of Health and Human Services (MDHHS) has issued Request for Proposal (RFP) No. 250000002670 to procure Prepaid Inpatient Health Plan (PIHP) services for managing comprehensive behavioral health services across three Michigan regions: Northern, Central, and Metro. The procurement seeks a nonprofit organization, public body, or public university to provide specialty behavioral health services for Medicaid beneficiaries, including individuals with mental illness, developmental disabilities, and substance use disorders. Specific service requirements include managing networks of providers, delivering services for various waiver programs like Children's Waiver and Habilitation Supports Waiver, and operating under the 1115 Behavioral Health Demonstration Waiver and Healthy Michigan Plan. Evaluation criteria will assess technical capabilities weighted at 1,110 points, with a minimum threshold of 888 points required for pricing consideration, and will examine vendor experience, organizational structure, statement of work, and narrative submission responses. Key dates include a Bidder's Conference and Rate Setting Meeting on August 11, 2025, with proposal submissions due by September 29, 2025, and an anticipated contract start date of February 24, 2026, with services beginning October 1, 2026.

The RFP includes provisions for qualified disabled veteran and service-disabled veteran-owned businesses, potentially offering preference in the evaluation process. Eligible bidders are limited to nonprofit organizations, public bodies/governmental entities, or public universities that can demonstrate the capability to operate across entire geographic regions. While specific incumbent vendors are not explicitly listed, the contract will be funded through capitated payments determined by actuarial services, with rates to be provided prior to the contract start date. The procurement emphasizes Michigan economic impact, considering factors such as employment, capital investments, and job creation. Performance will be monitored through extensive reporting requirements, including quarterly network adequacy profiles and annual network access plans, with potential financial incentives and withholds ranging from 0.75% to 2% of payments based on meeting quality and performance benchmarks. Although precise award values are not specified, the projected CCBHC funding across regions ranges from $328.6 million in State Fiscal Year 2023 to $654.6 million across different fiscal years, suggesting a substantial contract value.