Prepaid Inpatient Health Plan (PIHP) RFP

The State of Michigan is conducting a Request for Proposal (RFP) for a Prepaid Inpatient Health Plan (PIHP) with RFP number 250000002670, seeking a comprehensive behavioral health and substance use disorder management organization. The procurement targets a vendor to provide managed care services across multiple Michigan regions, as detailed in Appendix 1's PIHP Region Map. Key deliverables include managing Medicaid behavioral health services, implementing network adequacy procedures, ensuring data security, and maintaining HIPAA compliance. The RFP requires vendors to submit detailed narrative responses addressing specific submission questions, provide comprehensive insurance coverage, and demonstrate capabilities in managing behavioral health and substance use disorder payment responsibilities. Critical documents such as Schedule A (Statement of Work), Schedule J (Narrative Submission Questions), and Appendix 3 (Historical Cost and Utilization Data) outline the extensive requirements. The proposal is due on October 13, 2025, with the initial posting date of September 12, 2025, and vendors are expected to complete multiple documentation requirements including confidential treatment forms and vendor question worksheets.

The RFP does not explicitly specify set-aside designations or specific restrictions on respondent types, but includes comprehensive evaluation criteria focusing on organizational capability, service delivery approach, and financial stability. The contract appears to support Certified Community Behavioral Health Clinics (CCBHC), with Appendix 6 providing projected CCBHC funding details. While incumbent vendors are not directly mentioned, the procurement includes historical cost and utilization data that suggests an established service infrastructure. The contract will likely involve significant funding, with Appendix 3 providing historical cost data and Appendix 6 indicating projected CCBHC funding levels. Vendors must comply with federal provisions, including the Byrd Anti-Lobbying Certification, and demonstrate robust capabilities in managing complex behavioral health and substance use disorder services across multiple Michigan regions. Integration requirements include adherence to existing data security protocols, HIPAA compliance, and alignment with current Michigan Medicaid behavioral health payment structures.