Update: the Effective Date for One Care Plan Procurement Has Been Changed to 2019
MassHealth has decided to push out the effective date of the reprocurement for One Care plans by one year, from January 1, 2018 to January 1, 2019.
We have executed a two-year extension to the One Care demonstration and the health plans currently in the program to continue through December 31, 2018. MassHealth plans to reopen the opportunity for interested health plans to submit Letters of Intent and questions for the upcoming reprocurement in early 2017.
MassHealth will be providing more information about the new timeline in the near future. Future updates about One Care procurement will be posted both here and on COMMBUYS
MassHealth is Now Accepting Letters of Intent from Organizations Interested in Participating as One Care Plans in 2018
MassHealth is pleased to announce that it is accepting Letters of Intent (LOIs) from organizations interested in participating as One Care plans effective January 1, 2018. MassHealth will accept LOIs until 5:00 PM on Friday, August 12, 2016. MassHealth requests that interested organizations submit LOIs for informational and resource planning purposes. Submission of an LOI is voluntary and non-binding. Failure to submit a Letter of Intent will not preclude an organization from applying to participate as a One Care plan.
In addition, MassHealth will accept written questions from interested parties until 5:00 PM on Friday, July 29, 2016. MassHealth will post responses to questions which may help clarify this request on the Duals website under “Information for Organizations Interested in Serving as One Care Plans” and on COMMBUYS.
Please see announcement below for more information.
- LOI Announcement – Updated July 18, 2016
Note that the deadlines for written questions and LOI submission posted on COMMBUYS on July 7th, 2016 were extended. The extended deadlines are reflected in the updated LOI announcement posted here, and in the text above.
Initial ICO Procurement Documents for the beginning of the Demonstration in 2013 (last updated August 2012)
RFR Amendments and Q&As
MassHealth has issued two Amendments to the Duals Demonstration RFR and two Q&A documents, based on questions submitted by interested organizations. These documents are available below and on Comm-PASS under the Document Number 12CBEHSDUALSICORFR.
Please note that the deadline for responses to the RFR has been extended to August 20, 2012.
Request for Responses from Integrated Care Organizations
The Executive Office of Health and Human Services (EOHHS) is issuing a Request for Responses (RFR) to solicit proposals from Integrated Care Organizations (ICOs) to participate in the Duals Demonstration program. The purpose of this Demonstration is to improve quality of care and reduce health disparities, improve health and functional outcomes, and contain costs for dual eligibles. Under this program the selected ICOs will be accountable for the delivery and management of all covered medical, behavioral health, and long-term services and supports for their enrollees.
The RFR and related appendices are posted below and on Comm-PASS under the Document Number 12CBEHSDUALSICORFR.
- Duals Demonstration RFR
- Appendix A – Div BH Definitions
- Appendix B – BH Inpatient and Outpatient Services Definitions
- Appendix C – List of Covered Services
- Appendix D – Community Support Services
- Appendix E – BH Integration
- Appendix F – Acceptable Admitted Assets
- Appendix G – Emergency Services Program Providers
- Appendix H – Encounter Data Specifications file size 1MB
Data Book for Organizations Interested in Serving as Integrated Care Organizations
The Executive Office of Health and Human Services (EOHHS) has issued a Request for Responses (RFR) from Integrated Care Organizations (ICOs) for the Duals Demonstration. To assist respondents, EOHHS is providing a Data Book composed of two files.
One file includes summary demographic, utilization, cost and disease prevalence data for CY2009 and CY2010 based on Medicare parts A and B and Medicaid data. A second file provides information based on Medicare Part D data, including number of utilizers and prescriptions filled in CY2010, statewide and by county.
The Data Book files are posted at www.comm-pass.com. Please follow these instructions to access the files:
- Click on COMMBUYS .
- Near the bottom of the page, click on the hyperlink that reads: “Search for Solicitations.”
- When the Search page comes up, scroll down to the section that says “Search by Specific Criteria” and in the document number box, enter the following: 12CBEHSDUALSDEMOORGANIZATIONS.
- The Search result will appear as a hyperlink at the top of the new page. It should read: “There is 1 solicitation(s) found that match your search criteria.” Click on this sentence and it will take you to the Comm-PASS listing for this solicitation.
- Click on “view” (the eyeglasses on the right) and you will get the summary page for the Duals Demonstration: Information for Interested Organizations.
- Click on the blue folder-type tab called “Intent” and you will see all documents that have been posted for this topic, including the two Data Book files. To view the documents, click on the eyeglasses to the right of the title of each document.
FAQs and Other Materials for Organizations Interested in Serving as Integrated Care Organizations
The Executive Office of Health and Human Services (EOHHS) has issued a Request for Responses (RFR) from Integrated Care Organizations (ICOs) for the Duals Demonstration. The EOHHS and the Centers for Medicare and Medicaid Services (CMS) in the U.S. Department of Health and Human Services will jointly select ICOs to participate in this Duals Demonstration.
MassHealth is preparing responses to questions (FAQs) submitted to us by organizations interested in serving as ICOs. These FAQs are provided for informational purposes only and are not binding on EOHHS; to the extent there is any inconsistency or ambiguity between the RFR and the FAQs, it shall be resolved in favor of the RFR terms and provisions.
Please note that as EOHHS continues to work with CMS and other parties, changes, refinements, and additional information regarding these FAQs may occur.
MassHealth expects to post additional FAQs and other documents as questions arise and responses become available. These materials will also be posted on COMMBUYS .
- Duals Demonstration FAQs
- Duals Demonstration Covered Benefits
- Duals Demonstration FAQs for May 11, 2012
- Duals Demonstration – Target Population Current LTSS Providers
- Pharmacy Guidance
This information is provided by the Executive Office of Health and Human Services.