RFP-2023-DMS-06-MEDIC: Medicaid Care Management Dental Services
Division of Medicaid Services
The New Hampshire Department of Health and Human Services Division of Medicaid Services (“Department”) is seeking responses to this Request for Proposals (RFP) from qualified Vendors to provide dental services to eligible and enrolled Medicaid members age 21 and older through New Hampshire’s Medicaid managed care program, known as New Hampshire Medicaid Care Management (MCM). The Dental Medicaid Care Management (DMCM) must begin services by April 1, 2023. Department will select a Dental Organization (DO) that will work with the State, Providers, and Members to provide high-quality, value-based dental services on a Statewide basis. The DO must provide the following services, at minimum, which must be demonstrated through the responses in Appendix E – Vendor Technical Response to Mandatory Questions:
- Diagnostic and preventive dental services including an annual comprehensive oral examination, necessary x-rays or other imaging, prophylaxis, topical fluoride, oral hygiene instruction, behavior management and smoking cessation counseling, and other as determined by the annual update of Current Dental Terminology (CDT) codes D0100-D0999 and D1000-D1999.
- Comprehensive restorative dental services necessary to prevent or treat oral health conditions.
- Limited periodontic dental services.
- Oral surgery dental services necessary to relieve pain, eliminate infection or prevent imminent tooth loss.
- Transportation to dental appointments.
- Support for oral health through care management and care coordination.
- $1500 yearly limit on dental services, with the exception of preventive services.
- Removable prosthodontic coverage for the following individuals who qualify for services under the following criteria:
- Developmental Disability (DD) Waiver
- Acquired Brain Disorder (ABD) Waiver
- Choices for Independence (CFI) Waiver
- Nursing facility residents
- Cost sharing of 10% of the fees for the services for each visit, with the exception of diagnostic and preventive services, for individuals above 100% Federal Poverty Level (FPL) and up to 5% of annual household income.
To attend the Vendors Conference on September 8, 2022 @ 12:00 PM EST. please register here: https://nh-dhhs.zoom.us/meeting/register/tZUrcOChqjoiE9aFiJksN7QVOGWiVCDz1gNu
Release Date: August 25, 2022
Close Date/Time: September 30, 2022, 12:00 PM
Proposals Received: 2
- Appendix A – Form P-37 General Provisions and Standard Exhibits
- Addendum # 1 (09/09/2022)
- Addendum # 1, Exhibit I: Health Insurance Portability Act Business Associate Agreement (09/09/2022)
- RFP Vendors Conference Presentation (09/09/2022)
- Official Q&A (09/19/22)
- Score Sheet (10/18/2022)
- General Provisions, Form Number P-37
- Exhibit A - REVISIONS TO STANDARD CONTRACT PROVISIONS
- Exhibit B – Scope of Work – See Appendix G
- Exhibit C – Payment Terms – Placeholder
- Exhibit D: Certification Regarding Drug Free Workplace Requirements
- Exhibit E: Certification Regarding Lobbying
- Exhibit F: Certification Regarding Debarment, Suspension, and Other Responsibility Matters
- Exhibit G: Certification of Compliance with Requirements Pertaining to Federal Nondiscrimination, Equal Treatment of Faith-Based Organizations and Whistleblower
- Exhibit H: Certification Regarding Environmental Tobacco Smoke
- Exhibit I: Health Insurance Portability Act Business Associate Agreement
- Exhibit J: Certification Regarding the Federal Funding Accountability and Transparency
- Act (FFATA) Compliance
- Exhibit K: DHHS Information Security Requirements
- Appendix B – Contract Monitoring Provisions
- Appendix C – Culturally and Linguistically Appropriate Services (CLAS) Requirements
- Appendix D – Transmittal Letter and Vendor Information
- Appendix E – Mandatory Responses to Technical Components of the RFP
- Appendix F – Mandatory Responses to Cost Components for the RFP
- Appendix G – Example Draft Medicaid Care Management Dental Benefit
- Addendum #2 (09/14/2022)
- Addendum #3 (09/27/2022)
- Addendum # 3 Appendix G – Example Draft Medicaid Care Management Dental Benefit Exhibit B: Scope of Services - Example Draft (09/27/2022)
Draft Document includes:
- Exhibit B: Scope of Services - Example Draft
- Exhibit L: DO Implementation Plan - Example Draft
- Exhibit M: DO Proposal submitted in response to RFP-2023-DMS-06-MEDIC, by reference. - Example Draft
- Exhibit N: Liquidated Damages Matrix - Example Draft
- Exhibit O: Quality and Oversight Reporting Requirements - Example Draft
- Exhibit P: DO Program Oversight Plan - Example Draft
- Appendix G - Exhibit Q- DoIT Technical Requirements Workbook
- Appendix H –Cost Development