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April 7, 2006
 TennCare RFP for Managed Care Organization for the Middle Tennessee Area
The TennCare Bureau released the Request For Proposal (RFP) to
accept competitive bids from managed care organizations (MCOs) for
the Middle Tennessee Region. This RFP is the first time TennCare has
used the competitive bid process to recruit MCOs to the TennCare
service delivery network. The new RFP includes:
- An integrated behavioral health
model with the MCO managing health and mental health services
- Opportunity for additional bid
points at higher levels of financial risk
- Additional disease management
programs
- All children in the new MCOs will
receive outreach and screening
- Clear provider network
requirements to give enrollees access to needed primary and
specialty care
- An aggressive timeline for
accreditation from NCQA and data reports that allow for an
objective assessment of the quality of care
TennCare currently delivers health
care and mental health services through seven managed care
organizations, two behavioral health organizations (BHOs) and a
statewide administrative services organization (ASO). Interested MCOs must submit an intent to propose by April 21, 2006, and
completed proposals by 2:00 p.m. CDT May 19, 2006. The state
expects to sign contracts by June 26, 2006, with the new MCOs
serving enrollees beginning January 1, 2007.
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