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Medicaid explains the MississippiCAN procurement process and PSCRB review

In February of 2017, the Mississippi Division of Medicaid (DOM) issued a request for proposals (RFP) to re-procure contracts for the coordinated care program, MississippiCAN. After conducting a procurement process, which included consensus scoring and oral presentations, three contracts were awarded on June 15.

Unfortunately, there has been a lot of confusion and misinformation surrounding the MississippiCAN procurement. Let’s shed some light on this complicated process by providing a little background information.

It’s important to know, this contract award was not submitted to the Personal Service Contract Review Board (PSCRB) for approval because PSCRB staff had previously determined that they did not have purview. As such, DOM simply followed this guidance for the subsequent re-procurements.

After the Legislature authorized the coordinated care program in 2009, the original MississippiCAN contracts were procured and submitted to PSCRB in 2010. Since DOM follows the provisions set forth by PSCRB, there was a discussion (including questions and answers), between DOM and PSCRB about appropriate purview regarding these contracts.

As a result, it was determined that PSCRB did not have purview over the contracts, due to how the contracts are paid and the type of service (payment of medical claims). Unlike a traditional procurement where a contractor is paid a fixed price for services provided, coordinated care contractors are paid by capitation rates based on the number of members in the program each month. Therefore, PSCRB never considered the contracts.

When DOM re-procured for these services in 2013, the agency reached out informally to PSCRB again as to whether PSCRB had purview. PSCRB said it did not, based on the 2010 determination, since nothing had changed related to the services and how the contractors are paid.

Based on the previous determination, and that there were no changes in services or payment, DOM re-procured for these services in February of 2017 without submitting the contracts to PSCRB.

Prior to, and during the procurement process, DOM was clear with potential vendors and anyone who inquired that PSCRB did not review these contracts, and DOM did not receive questions or objections. Additionally, a PSCRB meeting was not in the publically available procurement schedule outlined in the RFP. Vendors who submitted a proposal in response to the RFP acknowledged that they had read, understood and agreed to all provisions of the RFP without reservation and without expectation of negotiation. Furthermore, per Section 3.1 of the RFP, submission of a proposal in response to the RFP constituted acceptance by the vendors of the conditions governing the procurement process.

Upon conclusion of the procurement, DOM executed the contracts according to the procurement schedule as outlined in the RFP. Execution of the contracts is required by the Centers for Medicare and Medicaid Services (CMS) prior to submission for review and approval. While the contracts have been signed and executed, they have not been submitted to CMS so that DOM may thoroughly consider the active protests to the awards. The contracts are not effective without CMS approval.

Gov. Phil Bryant has asked DOM to submit the contracts to PSCRB, and DOM has agreed to do that.

Of note, DOM used all applicable PSCRB rules and guidelines in procuring these contracts, and conducted the procurement as it would any other procurement that would fall under PSCRB purview. Anything stated to the contrary is a misrepresentation of the process.

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