Community Healthchoices

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Bidders ID: NBD13138965908624453
Due Date: Jul 15, 2026
Posted Date: Jun 2, 2026
Level of Government: State & Local
State: Pennsylvania
Agency: State Government of Pennsylvania
Category:
  • Q - Medical Services
Solicitation Number: 26-RFI-20429
Source: Members Only

General Information

Department for this solicitation:
Procurement

Date Prepared:

06/01/26
Types:
RFI

Advertisement Type:
Service Materials Service & Materials PW Construction Agency Construction Real Estate

Solicitation/Project#:
26-RFI-20429
Solicitation/Project Title:
Community HealthChoices

Description:
This RFI seeks information to assist the Department with suggested input and information concerning the current Community HealthChoices (“CHC”) agreement for the anticipated re-procurement of the CHC Managed Care Organizations (“CHC-MCOs”).

Department Information

Department/Agency:
Department of Human Services "prior DPW"
Delivery Location:

Ra Pwrficomments Pa Gov

County:

Statewide
Duration:

0

Contact Information

First Name:
Eric
Last Name:
McCoy

Phone Number:

(XXX-XXX-XXXX)
717-783-6924
Email:
RA-PWRFICOMMENTS@PA.GOV

Solicitation Information

Bids must be received by the purchasing agency on the Solicitation Due Date no later than the Solicitation Due Time as set forth in the solicitation. Any conflict between the dates and/or times contained in the solicitation itself or its attachments and this advertisement shall be resolved in favor of the solicitation.


Solicitation Start Date:

06/01/26

Solicitation Due Date:

07/15/26
Solicitation Due Time:

12:00 PM

Solicitation Opening Date:

07/15/26
Solicitation Opening Time:

12:01 PM

Opening Location:

This Is Not A Public Opening

No. of Addendums:

0

Amended Date:
06/01/26
Related Solicitation Files

Original Files
RFI CHC 2026 Final.pdf
Agreement Acronyms.pdf
Appendix A Program Requirements.pdf
Appendix B_Finanical Requirements.pdf
Appendix C_Reporting Requirements.pdf
Appendix D Revenue Sharing.pdf
Appendix E In Lieu of Services (ILOS).pdf
Exhibit A Covered Services List.pdf
Exhibit D Drug Services.pdf
Appendix E In Lieu of Services (ILOS).pdf
Exhibit F Quality Management and Utilization Management Program Requirements.pdf
Exhibit G Complaint, Grievance, and DHS Fair Hearing Processes.pdf
EXHIBIT H_Behavioral Health MCOs.pdf
EXHIBIT I_Guidelines for CHC_MCO Advertising Sponsership and Outreach.pdf
Exhibit M Participant Handbooks.pdf
Exhibit N Provider Directory.pdf
Exhibit Q Reporting Suspected Fraud, Waste, and Abuse.pdf
Exhibit S Provider Manual.pdf
Exhibit T Provider Network Composition Services Access.pdf
EXHIBIT U_Provider Agreement.pdf
Exhibit V CHC-MCO Requirements for Provider Terminations.pdf
Exhibit W(1) Critical Incident Reporting and Management and Provider Preventable Conditions Preventable Serious Adverse Events Reporting.pdf
Exhibit Y Guidelines for Sanctions Regarding Fraud, Waste and Abuse.pdf
EXHIBIT Z_Person Centered Service Planning.pdf
Exhibit CC_Financial Management Services.pdf
Exhibit DD(1) CHC-MCO Pay for Performance.pdf
Exhibit DD(2) Nursing Facility Quality Incentive Program.pdf
Exhibit EE Opiod Use Disorder Centers of Excellence.pdf


Attachment Preview

Department of Human Services
Request for Information (RFI)
Date: June 1, 2026
Community HealthChoices
Request for Information
June 1, 2026
TABLE OF CONTENTS
PART 1. GENERAL INFORMATION .................................................................................................4
1.1 Purpose of this Request for Information ............................................................................4
1.2 Request for Information Timeline .......................................................................................4
1.3 Disclaimers ..........................................................................................................................4
PART 2. BACKGROUND .........................................................................................................................................5
2.1 Background Information .....................................................................................................5
PART 3. REQUEST FOR INFORMATION SUBMISSION FORMAT .........................................................7
3.1 Response Submission ....................................................................................................... 7
3.2 Cover Letter ........................................................................................................................ 7
3.3 Conceptual Solutions and Strategies Response ...............................................................7
3.3.1 Program Requirements..............................................................................................7
3.3.2 Program Logistics......................................................................................................9
3.3.3 Medicare Integration………………………………………………………………………...9
3.3.4 Program Recommendations……………………………………………………………….9
3.3.5 Artificial Intelligence (AI)…………………………………………………………………...9
ATTACHMENTS
AGREEMENT ACRONYMS
APPENDICIES
APPENDIX A. PROGRAM REQUIREMENTS
APPENDIX B. FINANICAL REQURIEMENTS
APPEDNIX C. REPORTING REQUIREMENTS
APPENDIX D. REVENUE SHARING
APPENDIX E. IN LIEU OF SERVICES
EXHIBITS
EXHIBIT A. COVERED SERVICES LIST
EXHIBIT D. DRUG SERVICES
EXHIBIT E. PRIOR AUTHORIZATION GUIDELINES FOR THE CHC-MCO
EXHIBIT F. QUALITY MANAGEMENT AND UTILIZATION MANAGEMENT PROGRAM
REQUIREMENTS
2
Community HealthChoices
Request for Information
June 1, 2026
EXHIBIT G. COMPLAINT, GRIEVANCE, AND DHS FAIR HEARING PROCESSES
EXHIBIT H. COORDINATION WITH BEHAVIORAL HEALTH MANAGED CARE
ORGANIZATIONS
EXHIBIT I. GUIDELINES FOR CHC-MCO ADVERTISING, SPONSORSHIPS, AND
OUTREACH
EXHIBIT J. PARTICIPANT CHC-MCO SELECTION AND ASSIGNMENT
EXHIBIT M. PARTICIPANT HANDBOOK
EXHIBIT N. PROVIDER DIRECTORY
EXHIBIT Q. REPORTING SUSPECTED FRAUD, WASTE, AND ABUSE
EXHIBIT S. PROVIDER MANUAL
EXHIBIT T. PROVIDER NETWORK COMPOSITION/SERVICE ACCESS
EXHIBIT U. PROVIDER AGREEMENTS
EXHIBIT V. CHC-MCO REQUIREMENTS FOR PROVIDER TERMINATIONS
EXHIBIT W(1). CRITICAL INCIDENT REPORTING AND MANAGEMENT AND PROVIDER
PREVENTABLE CONDITIONS/PREVENTABLE SERIOUS ADVERSE EVENTS REPORTING
EXHIBIT Y. GUIDELINES FOR SANCTIONS REGARDING FRAUD, WASTE AND ABUSE
EXHIBIT Z. PERSON-CENTERED SERVICE PLANNING
EXHIBIT CC. FINANCIAL MANAGEMENT SERVICES
EXHIBIT DD(1). CHC-MCO PAY FOR PERFORMANCE
EXHIBIT DD(2). NURSING FACILITY QUALITY INCENTIVE PROGRAM
EXHIBIT EE. OPIOID USE DISORDER CENTERS OF EXCELLENCE
3
Community HealthChoices
Request for Information
June 1, 2026
PART 1. General Information
1.1 Purpose of this Request for Information
The Pennsylvania Department of Human Services (“Department”), Bureau of Procurement &
Contract Management issues this Request for Information (“RFI”) to gather input and information
concerning the current Community HealthChoices (“CHC”) agreement for the anticipated re-
procurement of the CHC managed care organizations (“CHC-MCOs”).
Specifically, this RFI seeks information to assist the Department in gathering stakeholder
feedback on the CHC agreement prior to issuing a Request for Applications. Through this RFI,
the Department hopes to become aware of and knowledgeable about stakeholder feedback
regarding the current CHC program and any opportunities to strengthen the program for the
benefit of participants.
The Department encourages all interested parties to provide feedback in response to this RFI or
any part thereof. A respondent may respond to all or any of the specific questions or topics
included in this RFI.
1.2 Request for Information Timeline
Event
Release RFI
RFI Responses Due
Date
June 1, 2026
July 15, 2026
The Department is requesting that all responses to this RFI be submitted by 12:00 p.m. on the
due date. Responses must be submitted electronically to the following email account with
“Community HealthChoices RFI” in the email subject line: RA-PWRFICOMMENTS@PA.GOV .
While the Department does not intend to respond to questions or clarifications during the RFI
response period, responders may submit administrative questions related to this RFI
electronically to: RA-PWRFICOMMENTS@PA.GOV using “Community HealthChoices RFI
question” in the email subject line. The Department may or may not respond based on the nature
of the question. The Department will post all answers provided online at:
http://www.emarketplace.state.pa.us.
1.3 Disclaimers
The Department is not liable for any costs or expenses incurred by respondents in the preparation
of responses related to this RFI.
4
Community HealthChoices
Request for Information
June 1, 2026
This RFI is issued for information and planning purposes only and does not constitute a solicitation
for future business, an offer for procurement, or any other type of current or future procurement
action, and is only intended to gather information and input. The Department will not award an
agreement on the basis of this RFI or otherwise pay for any of the information received.
The Department may use the information gathered through this process in the development of
future procurement documents; however, the Department does not guarantee that this will occur.
The Department will not return responses to this RFI. Respondents will not be notified of the result
of the review, nor will they be provided copies of it. If the Department issues a procurement
document, no vendor will be selected, pre-qualified, or exempted based on its participation in this
RFI process.
Respondents should be aware that the responses to this RFI will be public information and that
no claims of confidentiality will be honored. The Department is not requesting, and does not
require, confidential, proprietary information, or other competitively sensitive information to be
included as part of the RFI submission. Ownership of all data, material and documentation
originated, prepared, and provided to the Department during this RFI process will belong
exclusively to the Department.
PART 2. Background
2.1 Background Information
CHC is Pennsylvania’s mandatory managed care program for dually eligible individuals and
individuals with physical disabilities. CHC provides Medicaid, known as Medical Assistance
(“MA”) in Pennsylvania, physical health benefits as well as long-term services and supports
(“LTSS”) to those who qualify for that level of care.
CHC was developed to:
1. Enhance access to and improve coordination of medical care; and
2. Create a person-driven, long-term support system in which people have choice, control,
and access to a full array of quality services that provide independence, health, and
quality of life. LTSS help eligible individuals to perform daily activities in their homes
such as bathing, dressing, preparing meals, and administering medications.
The goals of the CHC program are:
1. Enhance opportunities for community-based living for participants through:
• Improved person-centered service planning and whole person care;
• Increased participant education;
• Empowerment; and
• Inclusion of a comprehensive support team chosen by the participant.
5
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