On Aug. 9, the New Mexico Human Services Department (HSD) announced its intent to grant Medicaid managed care organization (MCO) contracts to four health plans for the state's Medicaid managed care program known as Turquoise Care. According to an HSD press release, these contracts will be negotiated with BlueCross BlueShield, Presbyterian Health Plan, United Health Plan, and Molina Health Plan, and will start July 1, 2024.
“HSD spent the past several months reviewing the MCO contracts in depth and making improvements that focus on advancing and incentivizing health plan performance and ensuring that Medicaid customers have access to this information when they pick their health plan,” said HSD Acting Secretary Kari Armijo, according to the press release. “We will be negotiating contracts that reflect these improvements with the expectation of achieving better health outcomes for Medicaid customers.”
According to the press release, the state intends to negotiate the Medicaid contracts with BlueCross BlueShield, Presbyterian Health Plan, United Health Plan, and Molina Health Plan, but not with current MCO Western Sky Community Care. Furthermore, the HSD has chosen to reverse the cancellation of the Turquoise Care Request for Proposals (RFP) that occurred on January 30, 2023, to enable agency leadership to evaluate the process of procurement.
HSD has enlisted a consultant for suggestions on improving MCO contract enforcement and compliance, while also implementing various improvements with the current health plans that will become effective starting September 2023, according to the press release.
“The new contract go-live date will minimize disruption for Medicaid customers by allowing HSD to focus on the important work of recertifying eligibility for the 934,305 customers who are enrolled in the program,” said Armijo, according to the press release. “We want all Medicaid customers to be watching for their turquoise envelopes and submitting the required paperwork to make sure they stay covered if eligible and to help them transition to other health insurance coverage if they no longer qualify for Medicaid.”
The go-live date for the MCO contracts has been rescheduled to July 1, 2024, shifting from the originally intended date of Jan. 1, 2024. This adjustment will enable the HSD to finalize the Medicaid unwinding process, which requires recertification of all Medicaid recipients within a year-long timeframe extending until March 2024, according to the press release.