RFP - Prisoner Health Care and Pharmacy Services (5 years)

The Michigan Department of Technology, Management and Budget, on behalf of the Michigan Department of Corrections (MDOC), issued RFP 200000002287 for comprehensive Prisoner Health Care and Pharmacy Services spanning five years with potential for three additional one-year renewal periods. This procurement seeks integrated healthcare and pharmacy services for approximately 36,000 prisoners annually across MDOC correctional facilities, reentry centers, and select county jails, with bidders permitted to submit proposals for combined health care and pharmacy services or pharmacy services only. Required services encompass general primary care, psychiatric health care, pharmaceutical services, specialty care networks, utilization management, telehealth capabilities, on-site and off-site specialty referrals, on-site pharmacy operations at Duane Waters Health Center, dialysis centers, inpatient facilities, and secure hospital units. The contractor must maintain 24-hour medical provider coverage at designated facilities and manage comprehensive clinical staffing including psychiatrists, physicians, mid-level providers, nurses, pharmacists, and pharmacy technicians, all physically located in Michigan with appropriate credentialing and qualifications. Pricing is structured on a per-prisoner-per-month (PPPM) basis utilizing a risk-share model whereby costs above a target PPPM are shared 50/50 between MDOC and the contractor up to a cap amount, with the contractor bearing all costs exceeding the cap, while savings below the target are shared 85/15 in favor of MDOC. Key deadlines included a mandatory pre-proposal meeting on September 17, 2020, from 10:00 a.m. to 1:00 p.m. EST via Microsoft Teams (participation required for proposal evaluation), written questions due September 4 and September 24, 2020, with State responses posted by September 15 and October 5 respectively, and a proposal submission deadline of October 19, 2020, at 11:50 a.m. EST. The contract effective date is March 1, 2021, with a transition and implementation period through September 30, 2021 during which no payment is due, and full service operations commencing October 1, 2021, through September 30, 2026.

No set-aside provisions for disadvantaged or certified minority-owned businesses are specified in the RFP; however, qualified disabled veteran-owned businesses may receive consideration under Michigan Code of Laws Section 18.1261(8). The incumbent contractor is Corizon Health Inc., which has successfully performed under the current contract from June 1, 2016, through May 31, 2021, with the contract value totaling $715,733,760.00 for that period; contract year 4 (June 1, 2018 to May 31, 2019) showed $92,003,349.12 for prisoner healthcare services and $27,670,223.89 for pharmaceutical services. The MDOC will provide existing telehealth equipment, medical equipment, office infrastructure, personal protective equipment, and network connectivity, while the contractor assumes responsibility for clinical staffing, pharmaceuticals, specialty care coordination, dialysis equipment and supplies, certain durable medical equipment, and backup pharmacy costs. Historical claims data from June 1, 2016, through November 30, 2019, is available in the Schedule A-15 Data Book and supplemental actuarial analysis prepared by Milliman, Inc., with per-prisoner-per-month costs ranging from $149.63 to $218.69 for all claims and $27.74 to $38.41 for Medicare-repriced claims across the four contract periods analyzed. Hepatitis C medications are excluded from risk-share base and cap calculations, as are all Medicaid-eligible claims, and bidders must demonstrate expertise in pharmaceutical pricing through completion of detailed pricing exercises covering current inventory, high-cost specialty medications, and disease-specific therapies for Hepatitis C and HIV treatments.