Harrisburg, PA – The Department of Human Services (DHS) today announced applicants selected through a Request for Applications (RFA) process to administer Pennsylvania’s Community HealthChoices (CHC) program, the Medicaid managed care program that covers adults who are dually eligible for Medicare and Medicaid or who qualify to receive Medicaid long-term services and supports due to a need for the level of care provided in a nursing facility.
Selected applicants will now move to a readiness review period before the agreements are fully executed.
“Pennsylvania’s Community HealthChoices program is an investment in quality of life and freedom of choice for older Pennsylvanians and adults with disabilities covered under the Medicaid system,” said Human Services Secretary Dr. Val Arkoosh. “As one of our farthest-reaching and highest-cost programs, we are focused on constant quality improvement for participants’ health and well-being, and innovative, outcomes-driven efficiencies. We look forward to working with the selected applicants to advance these goals with this first re-procurement of the Community HealthChoices program.”
Applicants were selected through a competitive procurement process that included evaluation of soundness of approach, personnel qualifications, applicant qualifications, and understanding of the project. More information about the evaluation criteria can be found in the RFA. Those selected were the applicants whose applications received the highest overall scores for their zone(s). Selected applicants for each Community HealthChoices zone are as follows:
- Southeast: Aetna Better Health of Pennsylvania, Health Partners Plans, PA Health and Wellness, UPMC For You, and Vista Health Plan;
- Lehigh/Capital: Aetna Better Health of Pennsylvania, Health Partners Plans, PA Health and Wellness, UPMC For You, and Vista Health Plan;
- Northeast: Aetna Better Health of Pennsylvania, Health Partners Plans, PA Health and Wellness, UPMC For You, and Vista Health Plan;
- Northwest: Aetna Better Health of Pennsylvania, Health Partners Plans, PA Health and Wellness, UPMC For You, and Vista Health Plan; and,
- Southwest: Aetna Better Health of Pennsylvania, Health Partners Plans, PA Health and Wellness, UPMC For You, and Vista Health Plan
Selected applicants will soon begin a readiness review process that evaluates an applicant’s readiness to provide required services, including, but not limited to, network adequacy for contracted providers and the applicant’s ability to meet all Community HealthChoices service requirements. This process, which will take several months, ensures that the selected applicants can fully execute service requirements in compliance with the RFA and resulting agreements.
For more information on the Community HealthChoices re-procurement and requirements of the RFA, view the RFA here.