This RFP pertains only to those members enrolled in fee-for-service (FFS) Minnesota Health Care Programs plans. The resulting contract is expected to include medical services, behavioral health (both mental health and SUD treatment), inpatient hospital services, medical equipment and supplies, Early Intensive Developmental and Behavioral Intervention services, and certain home care services. The STATE has entered a contingent contract for a dental administrator, including authorization of services, and the decision to proceed with that contingent contract will be made in the autumn of 2025. If the STATE does not proceed with that contingent contract, dental services may be added to the contract awarded under this RFP. The objectives of the medical authorization program are to: 1) approve medically necessary services, eliminate medically unnecessary services, minimize unnecessary inpatient hospitalizations, and verify that the billing of services follows the STATE’s requirements; 2) provide a mechanism for authorizing specific procedures for medical appropriateness in a costeffective manner; and 3) provide data, information and expertise to the STATE within the scope of services requested.
