Department of Human Services Announces Applicants Selected for HealthChoices Program Procurement

Department of Human Services Announces Applicants Selected for HealthChoices Program Procurement

HARRISBURG, PA — The Department of Human Services announced applicants selected through a Request for Applications (RFA) for Pennsylvania’s HealthChoices program, the Medicaid physical health managed care program that provides healthcare coverage to more than 2.6 million people.  DHS is unable to move forward with the selections, however, due to the pendency of protests.

“Pennsylvania’s HealthChoices program is a lifeline for more than 2.6 million Pennsylvanians covered under the Medical Assistance program. This program not only helps with essential health services like doctors’ visits, routine and preventive care, and access to prescriptions necessary to live a healthy life – it also is an opportunity to greatly impact participants’ social and economic trajectory,” said Human Services Secretary Teresa Miller. “As one of our farthest-reaching and highest-cost programs, we are committed to constant quality improvement that focuses on participants’ health and well-being, and innovative, outcomes-driven efficiencies.”

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Applicants were selected through a competitive procurement that evaluated applicants’ soundness of approach, personnel qualifications and staffing and prior experience and performance. More information about evaluation criteria can be found in the RFA. Applicants selected were the top scoring applicants for their zone. Selected applicants for each service zone are as follows:

  • Southeast: Geisinger Health Plan, Health Partners Plans, UnitedHealthCare, UPMC for You, and Vista Health Plan (Keystone First);
  • Lehigh/Capital: Gateway Health, Geisinger Health Plan, Health Partners Plans, UPMC for You, and Vista Health Plan (AmeriHealth Caritas);
  • Northeast: Geisinger Health Plan, Health Partners Plans, UPMC for You, and Vista Health Plan (AmeriHealth Caritas);
  • Northwest: Geisinger Health Plan, Health Partners Plans, UPMC for You, and Vista Health Plan (AmeriHealth Caritas); and,
  • Southwest: Gateway Health, Geisinger Health Plan, Health Partners Plans, UPMC for You, and Vista Health Plan (AmeriHealth Caritas).
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At the time of this release, two non-selected applicants filed protests of their non-selection.  Due to the filing of these protests, DHS may not take any further action on the procurement until the protests are resolved.

For more information on the HealthChoices procurement and requirements of the RFA, view the RFA here.

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