The Washington State Health Care Authority (HCA) has issued a Request for Proposal (RFP) that will allow managed care organizations (MCOs) to expand to areas in the state in which they are not currently serving if they have demonstrated successful performance in other regions. The RFP is limited to MCOs already serving Washington State. RFP responses are due July 1 and the apparent successful bidders will be announced July 24. The expansion will begin January 1, 2021.
The HCA currently has contracts with five Medicaid MCOs to provide services to Medicaid enrollees under the Integrated Managed Care (IMC) program. The HCA awards contracts to the MCOs based on 10 service areas. Currently, two MCOs serve all 10 regions and the other three MCOs serve less than 10 regions. There are two regions that are served by all five MCOs and the other regions are served by three or four MCOs, depending on the region.
The HCA also announced that it intends to distribute new Medicaid enrollees who do not select an MCO preference, more evenly among the five MCOs. This includes discontinuing auto-assignment of new enrollees to any MCO that has a statewide market share of more than 40 percent. (Shirley Prasad, email@example.com)