State Rebids Medicaid Dental and CHP+ Vendor Contracts

Molly PereiraFeatured News

The Colorado Department of Healthcare Policy and Financing (HCPF) is beginning the process of rebidding vendor contracts for the Medicaid dental contract (currently serviced by DentaQuest) and the CHP+ dental contract (currently serviced by Delta Dental). By mid-2019, HCPF plans to use one administrative service organization as the vendor for both Medicaid dental and CHP+ dental.

HCPF is requesting input from the public as it designs the new vendor contract parameters. Specifically, HCPF is seeking input on:

  • ways to avoid waste and improve cost savings in administering the Medicaid and CHP dental benefits,
  • ways to better integrate dental care with primary care,
  • special programs that can be implemented to reduce costs for higher risk populations,
  • ways to improve data sharing and collaboration,
  • ways to incentivize patient-centered care delivery,
  • innovations in payment models and benefits, and
  • risk and payment models for vendors.

The CDA will be submitting comments during this phase of the contracting process. We encourage interested dentists and stakeholders to submit comments as well. Some of the CDA’s priorities for inclusion in this rebid include ensuring that a selected vendor can:

  • provide a high level of service and streamlined billing processes for participating dentists,
  • provide support services to offset state and federal mandates unique to publicly funded programs (like translation services or even e-prescribing technology solutions for opioid prescriptions),
  • accommodate incentive models that would increase prevention (such as an increase in annual maximum benefits if preventive services are utilized),
  • implement incentive models for provider recruitment in targeted areas,
  • provide robust program integrity services that alleviate contingency audit requirements, and
  • provide benefits administration for expanded senior adult benefits, should they be added in the future.

The CDA will share our comments with members once submitted to the state. All comments must be submitted to by Thursday, July 12 at 3 p.m.