PUBLIC INFORMATION & COMMUNICATIONS
Turquoise Care Medicaid Managed Care Request for Proposals (RFP# 23-630-8000-0001) and Procurement Library
The purpose of this Request for Proposals (RFP) is to solicit competitive, sealed proposals from Managed Care Organizations (MCOs) to provide services to Members of the New Mexico Medicaid managed care program, hereinafter referred to as “Turquoise Care,” beginning in 2024.
This RFP sets forth the New Mexico Human Services Department’s (HSD’s) process for soliciting, evaluating, and scoring proposals, and for selecting Contractors to provide the scope of work identified in the RFP and comply with the terms in the Model Contract (Appendix L).
Although the resulting Managed Care Services Agreement (“Contract”) is exempt from New Mexico’s procurement code, HSD, the New Mexico Children, Youth, and Families Department (“CYFD”), the New Mexico Early Childhood Education and Care Department (“ECECD”), and the New Mexico Behavioral Health Purchasing Collaborative (“the Collaborative”) will follow the procurement process set forth in New Mexico’s procurement code (NMSA 1978, Section 13-1-98.1 [1989] Hospital and health care exemption).
References to HSD in the RFP and the Contract related to Behavioral Health also include the Collaborative, whether or not such sections explicitly reference the Collaborative. The focus of New Mexico’s current Medicaid managed care program has been to strengthen facets of the program that are fundamental to delivering high quality and effective health care services to members, while advancing emerging managed care strategies and practices to improve the efficacy of services, efficiency of service delivery, and member satisfaction. While this area of focus will continue to be foundational to the program, Turquoise Care will introduce new and transformational practices for 2024 and beyond, improve access for Members, drive even greater accountability, and promote delivery of quality care over volume.
Offerors may submit questions in writing by emailing the Procurement Manager Charles Canada at turquoisecare.rfp@hsd.nm.gov. (Please note that this address has been changed with the State’s migration from @state.nm.us to @hsd.nm.gov). The questions and answers will be posted in PDF format on this page. Offerors are encouraged to check this page regularly for updates.
The Procurement Manager has established an online procurement library on this page. The procurement library includes electronic documents and web links. Offerors are encouraged to review the materials contained in the online procurement library. HSD may continue to update the materials in the procurement library after this RFP is released; however, Offerors will be evaluated based upon the content contained in the RFP procurement library as of the final date for HSD to post responses to questions (see RFP Section 2.1, Procurement Schedule). Prior to that date, Offerors are advised to check the procurement library frequently to see if new and revised material has been added.
- Amendment #5 (October 24, 2023) Turquoise Care Medicaid Managed Care Request for Proposals (RFP# 23-630-8000-0001) (Word)
- Amendment #5 (October 24, 2023) Turquoise Care Medicaid Managed Care Request for Proposals (RFP# 23-630-8000-0001) (PDF)
- Turquoise Care Medicaid Managed Care Request for Proposals (RFP# 23-630-8000-0001) Appendix L Model Contract (Issue date October 24, 2023) (Word)
- Amendment #4 (September 28, 2023) Turquoise Care Medicaid Managed Care Request for Proposals (RFP# 23-630-8000-0001) (Word)
- Amendment #4 (September 28, 2023) Turquoise Care Medicaid Managed Care Request for Proposals (RFP# 23-630-8000-0001) (PDF)
- Turquoise Care Medicaid Managed Care Request for Proposals (RFP# 23-630-8000-0001) Appendix L Model Contract (Issue date September 28, 2023) (Word)
- Amendment #3 (September 21, 2023) Turquoise Care Medicaid Managed Care Request for Proposals (RFP# 23-630-8000-0001) (Word)
- Amendment #3 (September 21, 2023) Turquoise Care Medicaid Managed Care Request for Proposals (RFP# 23-630-8000-0001) (PDF)
- Turquoise Care Medicaid Managed Care Request for Proposals (RFP# 23-630-8000-0001) Appendix L Model Contract (Issue date September 21, 2023) (Word)
- Turquoise Care Medicaid Managed Care Request for Proposals (RFP# 23-630-8000-0001) Appendix L Model Contract (Issue date September 21, 2023) (PDF)
- Amendment #2 (11/15/2022) Turquoise Care Medicaid Managed Care Request for Proposals (RFP# 23-630-8000-0001) (Word)
- Amendment)#2 (11/15/2022) Turquoise Care Medicaid Managed Care Request for Proposals (RFP# 23-630-8000-0001) (PDF
- Amendment #1 (10/11/2022) Turquoise Care Medicaid Managed Care Request for Proposals (RFP# 23-630-8000-0001) (Word)
- Amendment #1 (10/11/2022) Turquoise Care Medicaid Managed Care Request for Proposals (RFP# 23-630-8000-0001) (PDF)
- Turquoise Care Medicaid Managed Care Request for Proposals
(RFP# 23-630-8000-0001) (Word) - Turquoise Care Medicaid Managed Care Request for Proposals
(RFP# 23-630-8000-0001) (PDF) - Turquoise Care Medicaid Managed Care Request for Proposals
(RFP# 23-630-8000-0001) Appendix L Model Contract (Word) Issue date September 30, 2022 - Turquoise Care Medicaid Managed Care Request for Proposals
(RFP# 23-630-8000-0001) Appendix L Model Contract (PDF) Issue date September 30, 2022 - Turquoise Care Medicaid Managed Care Request for Proposals
(RFP# 23-630-8000-0001) Data Book Narrative (PDF) - Turquoise Care Medicaid Managed Care Request for Proposals
(RFP# 23-630-8000-0001) Data Book Exhibits (Excel)
Turquoise Care Questions & Answers
- NM HSD Official Responses to Questions for RFP Questions Submitted for Turquoise Care RFP #23-630-8000-0001 for Model Contract Negotiation Questions and Proposed Language (Word)
- Turquoise Care Medicaid Managed Care Request for Proposals (RFP# 23-630-8000-0001) Appendix L Model Contract (Issue date September 28, 2023) (PDF)
- NM HSD Official Responses to Questions for RFP Questions #23-630-8000-0001 (Word)
- NM HSD Official Responses to Questions for RFP Questions #23-630-8000-0001 (PDF)
Turquoise Care Medicaid Managed Care Quick Reference Material
Turquoise Care Pre-Proposal Conferences for Potential Offerors
Procurement Library
This section contains documents and links related to this request for proposal that will assist offerors in the preparation of a responsive proposal.
Click on each heading below for information and links regarding the heading.
New Mexico Medicaid Managed Care
NM Medicaid 1115 Waiver
- 1115 Waiver Renewal Application (Current)
- 1115 Waiver (2021)
- 1115 Waiver (2019)
- 1115 Waiver (2017)
- 1115 Waiver Demonstration Reports
Managed Care Contract Fact Sheets
- Centennial Care 2.0 Fact Sheet
- Centennial Care 1.0 Fact Sheet
- Centennial Care: Care Coordination
- Centennial Care: Community Benefit Fact Sheet
- Centennial Care: Home Visiting Fact Sheet
NM Medicaid Centennial Care: Contracts
NM Medicaid Managed Care Policy Manual
NM Medicaid Centennial Care 2.0: MCO Letters of Direction (LODs)
NM Medicaid Managed Care Organizations Value Added Services
NM Medicaid Information, Trainings and Forms
(Links updated 10/25/2022)
- Nursing Facility Level of Care (NFLOC) Guidelines, Trainings and Forms
- Community Based Services
- Centennial Care Community Benefits Member Agreement
- Centennial Care Benefits Questionnaire
- Centennial Care Community Benefits Brochure
- Agency Based Community Benefit (ABCB) Personal Care Services (PCS) Allocation Tool
- ABCB Personal Care Transfer – Closure Form
- Self-Directed Community Benefit (SDCB) Authorized Agent Form
- SDCB Employer of Record (EOR) Self-Assessment Form
- Involuntary Termination SDCB to ABCB Form
- SDCB Self Direction Provider Attestation Form – CMS Final Rule
- SDCB Budget Reduction Form
- SDCB Rate Increase Form
Behavioral Health
- Office of Peer Recovery and Engagement (OPRE)
- Office of Substance Abuse Prevention (OSAP)
- NM Strategic Housing Plan
- CareLink NM Health Homes
- New Mexico Behavioral Health Collaborative
- NM Behavioral Health Planning Council (NMBHC)
- 2022 BHPC Orientation Manual
- BHPC Roster
- BHPC Bylaws, Policies and Procedures
- 2022 BHPC Schedule
- BHPC Meeting Agendas and Minutes
- BHPC Subcommittee Agendas and Minutes
Reports
- Medicaid Eligibility Reports
- Centennial Care Program Report Templates
- #1 – Native American Members Report Instructions
- #1 – Native American Members Template
- #2 – Call Center Instructions
- #2 – Call Center Report
- #3 – Ntwk Adq Instructions
- #3 – Ntwk Adq Template
- #4 – Community Benefit Instructions
- #4 – Community Benefit Template
- #5 – Admissions and Readmissions Instructions
- #5 – Admissions and Readmissions Template
- #6 – Care Coordination Instructions
- #6 – Care Coordination Template
- #8 – LOC Instructions
- #8- LOC Template
- #12 – Provider Satisfaction Template Appendix A
- #12 – Provider Satisfaction Survey Instructions
- #15 – Audited HEDIS Results Report Instructions
- #18 – UM Program Desc Pln and Eval Instructions
- #20 – DM Pgm Desc and Eval Instructions
- #22 – QM_Q1 Description and work Plan
- #23 – QM_Q1 Program Annual Evaluation
- #25 – CAHPS Results Report Instructions
- #27 – Activities of Advisory Board Instructions
- #35 – EVV Instructions
- #35 – EVV Template
- #36 – Critical Incident Instructions
- #36 – Critical Incident Template
- #37 – Griev and App Instructions
- #37 – Griev and App Template
- #38 – Provider Training and Outreach Plan and Eval Instructions
- #42 – Prior Auth Instructions
- #42 – Prior Auth Template
- #44 – Pharmacy Instructions
- #44 – Pharmacy Template
- #47 – Claims Activity Instructions
- #47 – Claims Activity Template
- #48 – PCMH Instructions
- #48 – PCMH Template
- #49 Provider Network_Dev_and_Mgmt_Plan_Eval_Instructions
- #55 – GEO Access Instructions
- #55 – GEO Access Template
- #56 – Program Integrity Instructions
- #56 – Program Integrity Template
- #63 – DD Specialty Dental Instructions
- #63 – DD Specialty Dental Template
- #64 – Jackson Class Mem Instructions
- #64 – Jackson Class Mem Template
- BH DSIPT Report Template
- Ad Hoc Reports
- In addition to required reporting, ad hoc reports may be requested at any time as required by HSD.
- Financial Report Templates
- Financial Management Reporting Requirements
- FIN Service Categorization Logic
- FIN-13a Template
- FIN-14 Template
- FIN-16 Template
- FIN-17 Template
- FIN-23 Template
- FIN-24 Template
- FIN-25 Template
- FIN-29 Template
- FIN-BHPkg Template
- FIN-PHPkg Template
- FIN-LTSSPkg Template
- FIN-OAGBHPkg Template
- FIN-OAGPHPkg Template
- 1115 Demonstration Reports
- Delivery System Improvement Performance Targets (DSIPTs) Report Templates
State and Federal Resources
- Medical Assistance Division: NMAC Program Rule and Eligibility Rule Manual
- Program Rules
- Supplements to MAD NMAC Program Rules
- New Mexico Administrative Code (NMAC)
- HSD NM Medicaid State Plan
- HSD- Medical Assistance Division State Plan Amendments
- 5010 HIPAA – Guides, FAQs and Submission Procedures
- CMS Medicaid and Managed Care
- CMS Medicaid and CHIP Managed Care Final Rule
- CMS Behavioral Health Services and Mental Health Parity (MHPAEA)
- CMS Federal Policy Guidance
- NM Campaign Contribution Disclosure Form
- Disclosure of Federal Lobbying Activities Form