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In order to best protect confidential and other important data, the ODJFS website will no longer support several outdated web browsers. Effective December 5, Internet Explorer 6 or older, Opera 4 or older and Netscape Navigator will no longer work on ODJFS sites that are https-enabled. Individuals can download the most recent version of Internet Explorer here and the most recent version of Opera here.

Request for Applications (RFA)#: JFSR1213-07-8019 for the Ohio Medicaid Managed Care Program


All documents in .pdf format

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Announcement Letter

The Ohio Department of Job and Family Services (ODJFS) announces the Request for Applications, RFA#: JFSR1213078019.  ODJFS is seeking Applicants to enter into a provider agreement for the delivery of medically necessary Medicaid covered health care services, and care coordination, to Ohio’s managed care populations under a full risk arrangement. Successful Applicants will be expected to materially improve health outcomes for Ohio’s Medicaid managed care populations by providing adequate access to all Medicaid covered medically necessary services and delivering efficient and effective coordinated care.  The services required as part of the contract include, but are not limited to: providing covered health care services, establishing and contracting with a credentialed provider network, utilization management, care management, provider services, financial management, claims management, sufficient information systems, promoting coordination and continuity of preventive health services and other services necessary to improving health outcomes. In order to assure the delivery of the above, rigorous contractual expectations, including comprehensive performance standards and monitoring processes will be utilized.


  Actual RFA

 

Final Q&A Document click here

 

Summary list of changes to RFA and to Appendices - ALL POTENTIAL VENDORS SHOULD ENSURE THEY HAVE THE MOST CURRENT APPENDICES AND COPY OF THE RFA. ALL DOCUMENTS ARE CURRENT AND POSTED ON THIS WEB PAGE.

 



 APPENDICES

Appendix A
         Applicant Information & Attestation/Acknowledgement
Appendix B         Applicants Contract/Compliance Experience
Appendix B         Exhibits B 1 through 3
Appendix C         Health Outcomes
Appendix C         Health Outcomes Scoring Key
Appendix D         Care Coordination
Appendix D         Care Coordination Scoring Methodology
Appendix E         Provider Relations

Appendix E-1      Application for Submission          
Appendix E-2      Scoring and Example