Request for Applications (RFA)#: JFSR1213-07-8019 for the Ohio Medicaid Managed Care Program
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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.
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 RelationsAppendix E-1 Application for Submission
Appendix E-2 Scoring and Example