MO HealthNet Managed Care Program

The State of Missouri Department of Social Services (DSS) is seeking qualified health‑plan providers to operate the MO HealthNet Managed Care Program for all Medicaid/CHIP beneficiaries across the state. The contract will be awarded for a one‑year term with the possibility of renewal, and the selected health plan must deliver both a General Plan and a Specialty Plan on a capitated, per‑member‑per‑month (PMPM) basis. Proposals must be submitted electronically via MissouriBUYS by the September 2, 2026 deadline and must include extensive technical, pricing, and compliance exhibits. Vendors must be licensed as a health‑maintenance organization in Missouri, meet federal and state Medicaid requirements, and comply with a range of statutory certifications (e.g., anti‑boycott, E‑Verify, federal funding ID). • Scope: Provide comprehensive managed‑care services (primary, specialty, behavioral health, pharmacy, etc.) for all eligible MO HealthNet members statewide. • Payment: Capitated PMPM rates as defined in the attached actuarial memoranda. • Geographic coverage: All counties in Missouri, divided into four regions (Central, Eastern, Southwestern, Western). • Mandatory compliance: Certificate of authority, E‑Verify, anti‑discrimination against Israel Act, federal debarment checks, and numerous business‑entity certifications. • Submission format: Electronic through MissouriBUYS; required exhibits include technical qualifications, team qualifications, methodology, pricing pages, and multiple compliance forms. • Pre‑proposal teleconference: July 21, 2026 (optional but encouraged). • Contract period: One year from effective date, with potential extensions.