DMO Request for Proposals Coming?

TDMR has been asked several times recently if we have any knowledge of an upcoming RFP (request for proposals) for dental management organizations.  There have been rumors flying around for well over a year now that Texas Health and Human Services would be putting out such an RFP at some point.

Back in the day, late 2016, we even talked with someone at HHS about this and were told directly that they couldn’t talk about it and there would be no advance notice until such an RFP was issued.  This only makes sense for good contract management and fairness to those companies who may want to send in a proposal.

Others we spoke with at the time who were in the DMO industry and wanting to come into Texas told us that an RFP was very likely sometime last year.  We even reported that Delta Dental, which was one of the original three DMOs brought in back in 2012 but dropped out, was sending letters to Texas dentists soliciting them for a new Texas program.

What is the story now almost a year and a half later? Well, we haven’t heard anything new.

In fact, things are pretty quiet on the DMO front these days. TDMR has received no complaints in the last six months or so on either of the current DMOs – MCNA and Dentaquest.  Things seem to have quietened down with the payment holds and poor service and possibly even credentialing.  We’ll send out our annual survey early next month to find out.

Also, HHS Executive Commissioner Charles Smith just made a presentation this week to the Senate Health and Human Services Committee on Medicaid managed care.  Slide 8 of his presentation shown below only continues to show two DMOs with no hint of expansion.

We suppose that since HHS issued RFPs on January 29 for STAR and CHIP managed care services that this has fueled some speculation that one for DMOs will also soon be issued.

Our opinion based only on the above is that the state appears quite satisfied with the current arrangement and is unlikely to change it for a while longer.  Dental is a minor piece of the Medicaid pie as far as spending is concerned so there is no rush as has obviously been the case to date.

Please email us if you know anything else.

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