TennCare - 2021 MCO Procurement
- RFP 31865-00603
- Amendment #6
- Amendment #5
- Amendment #4
- Amendment #3
- Amendment #2
- Amendment #1
- Attachment 6.1 - Response Statement of Certifications & Assurances
- Attachment 6.2 - Technical Response & Evaluation Guide
- Attachment 6.3 - Score Summary Matrix
- Attachment 6.4 - Procurement Library (see expandable section below)
- Attachment 6.5 - Information System Profile
- Attachment 6.6 - Information Systems Organizational Profile
- Attachment 6.7 - HIPAA Business Associate Agreement
- Attachment 6.8 - Data Book and Supplemental Reports (see expandable section below)
- Attachment 6.9 - Pro Forma Contract
- Attachment 6.10 - MCO Manual
- Attachment 6.11 - Respondent Community Investment Template
- Attachment 6.12 - Contract Accountability Template
- Attachment 6.13 - Respondent Attestation
- Attachment 6.14 - Comment and Question Template
* Click here to download zip file containing all MCO Procurement documents, unsorted. (does not include Amendments)
- Background Information
- 2019 Census Data on Income and Poverty in TN - The Sycamore Institute
- 2019 Income Poverty Education and Insurance in TN's 95 Counties - The Sycamore Institute
- 2020 County Health Profiles - All Tennessee Counties - The Sycamore Institute
- 2020 HEDIS Comparative Analysis of Audited Results from TennCare MCOs
- Current Dental Benefits Manager (DBM) Contract - DentaQuest
- Current Pharmacy Benefits Manager (PBM) Contract - Optum
- Delivery System Transformation One Page Overview
- LTSS One Page Overview
- Managed Care Model One Page Overview
- TennCare FY2019 Annual Report
- TennCare Mission Vision and Values Statement
- TennCare One Page Overview
- TennCare Recommended FY2021 Budget
- TennCare Timeline
- TN Health Care Capacity Dashboard - The Sycamore Institute
- TN Health System Performance - 2020 Commonwealth Fund
- Behavioral Health
- Allowing for reimbursement of services provided by LDAC IIs without a requirement of supervision
- National Provider Identifier Usage for Licensed and Non-licensed Clinicians
- National Provider Identifier Usage for Licensed and Non-licensed Clinicians - ADDENDUM
- Provider Identification Usage on Submitted Transactions
- Tennessee Health Link Outcome Payment Capitation
- Tennessee Health Link re: Look Back - Claims Analysis
- THL Provider Operating Manual 2021
- Update: Medication Assisted Treatment - Methadone Treatment Rate
- Long-Term Services and Supports
- Acceptable Use Policy: Rules of Behavior Network Access Rights and Obligations
- ECF CHOICES Group 7 and 8 Acuity Score Memo
- Guidance on Flexible Scheduling
- Medical Necessity - Enrollment Criteria
- Routing Referrals for Medicaid Eligible
- Routing Referrals for Non-Medicaid Eligible
- Screening for Eligibility Enrollment
- SPOE Protocol
- TennCare LTSS: A Guide for Pre Admission Evaluation Applications
- Transition of Member between MCOs
- Transitions between HCBS Groups
- Transitions from HCBS to NF Protocol
- Transitions from NF to HCBS Protocol
- Use of EVV in Consumer Direction Protocol
- Withdrawal from Consumer Direction
- Program Integrity
- Provider Relations
- Quality Improvement
- 2020 Annual Provider Engagement Plan Guidance
- 2021 Guidance on setting efficiency threshold
- Annual Quality Metrics Technical Specifications v2.0
- PCMH Detailed Business Requirements
- PCMH Detailed Business Requirements Appendix
- PCMH Program Overview
- PCMH Provider Operating Manual
- PY2021 PCMH and THL Thresholding Guidance
- TennCare MAT Quality Metric Specifications Guide
- CY22 CHOICES Rate Exhibits
- CY22 Non-CHOICES Rate Exhibits
- CY22 CoverKids Rate Exhibits
- CY22 Preliminary Capitation Rates
- CY22 RFP Supplemental Reports
- Re-Procurement Supplemental Report Index