Illinois Plans Rebid of Medicaid Managed Care Contracts for 2025-2026
New Bidding Process Anticipated for Dual-Eligible Special Needs Plans and HealthChoice Illinois
September 9, 2024 – The Illinois Department of Healthcare and Family Services (HFS) has announced its plan to rebid its Medicaid managed care contracts for the years 2025 and 2026. The move will begin with the Medicare-Medicaid Alignment Initiative (MMAI) demonstration contracts for individuals who are dually eligible for both Medicaid and Medicare.
The rebidding process was expected to commence with a procurement release in August 2024 for a new fully integrated dual-eligible special needs plan (FIDE SNP) to succeed the MMAI program. However, as of August 28, 2024, HFS had not yet released the new procurement. This has stakeholders attentive to upcoming announcements.
The MMAI program, which has been operational under contracts awarded back in 2017 to several Managed Care Organizations (MCOs), including CVS/Aetna, Blue Cross Blue Shield of Illinois, Humana, Centene/Meridian Health Plan, Molina, and Cook County’s CountyCare Health Plan, currently serves approximately 90,000 beneficiaries. The current MMAI contracts are set to expire on December 31, 2025.
Additionally, HFS is preparing to issue a procurement for the Medicaid HealthChoice Illinois (HCI) contracts for the general Medicaid population in mid-2025. These contracts are set to expire at the end of 2026. To aid in the development of the forthcoming HCI procurement, HFS has planned Listening Sessions throughout the fall of 2024 to gather feedback from consumers and other stakeholders. Approximately 80% of the state’s Medicaid beneficiaries are currently enrolled in an HCI Managed Care Organization (MCO).
The rebidding process reflects Illinois’ ongoing commitment to improving the coordination and quality of care for its Medicaid beneficiaries, particularly those with dual eligibility, by integrating services that cater comprehensively to their health care needs.
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