Additional Pharmacy Services Updates to Michigan Managed Care Request for Proposal

Contact: Jennifer Smith 517-241-2112

For Immediate Release: April 1, 2015

LANSING, Mich. – The Michigan Department of Community Health (MDCH) today announced changes to the upcoming request for proposal (RFP) for the Comprehensive Health Plan Contract for Michigan’s Medicaid Health Plans (MHP). The Comprehensive Health Plan Contract provides health care services to Michigan’s Medicaid managed care beneficiaries, and is being rebid during fiscal year 2015 for new contracts beginning in fiscal year 2016.

The upcoming RFP allows for the continuation of the carve-in of pharmaceutical drugs, but also includes a common formulary for all managed care entities by January 1, 2016. These modifications will result in cost savings through pharmaceutical rebates and state-level administrative efficiencies that are associated with moving to a common formulary, and will also allow for a more streamlined process for consumers and providers.

The RFP includes a well-defined common floor that is consistent not only on preferred drugs but the coverage parameters tied to each drug as well. Health plans can be less restrictive but not more restrictive than the common formulary coverage parameters.

Changes to the RFP are a culmination of valuable feedback and discussions during the budget process, and allow for necessary adjustments to get to a single formulary and preferred drug list for all Medicaid Health Plans by January 1, 2016. MDCH will convene and lead the Medicaid Health Plans to collaboratively develop the single formulary and preferred drug list and will lead future efforts to develop a similar approach for all Medicaid lines of business including fee-for-service and managed care by January 1, 2017.

Michigan previously announced changes to the RFP service area locations and requirements, as well as a new Medicaid coverage group and the rebid timeline. Michigan's Prosperity Regions will be used for this bid. The state also intends to convert its current Children's Health Insurance Program (CHIP) program, called MIChild, from a stand-alone CHIP program to a Medicaid expansion group.  This change is contingent on approval by the Centers for Medicare and Medicaid Services (CMS). 

The RFP will be released in May of 2015, with responses due in August of 2015. Current contract end dates have been extended from September 30, 2015 to December 31, 2015. New contracts as a result of the rebid will begin January 1, 2016. 

Potential bidders interested in additional information regarding this pre-bid announcement should send questions by email no later than April 17, 2015 to Kristi Broessel at broesselk@michigan.gov. All questions that MDCH receives in response to this announcement and responses will be posted on the MDCH website for easy reference by all potential bidders.

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