Healthy Kids Dental Program for MDHHS

Background
The Michigan Department of Health and Human Services (MDHHS) aims to enhance the quality and accessibility of oral health services for its younger Medicaid population through the Healthy Kids Dental (HKD) program. This program serves approximately 955,000 individuals statewide, primarily those who are medically underserved and from lower socioeconomic backgrounds, including various minority groups.

The HKD model is designed to function similarly to commercial dental plans, focusing on innovative and collaborative approaches to improve oral health outcomes and address barriers faced by enrolled populations.

Work Details
The Contractor will be responsible for administering all dental plan benefits as outlined in the Statement of Work. Key responsibilities include:
- Total benefit administration including claims processing, provider network management, education and outreach, credentialing, quality assurance, community collaboration, utilization management, and grievance handling.
- Collaborating with community organizations to enhance preventive dental service utilization and reduce oral disease.
- Providing comprehensive dental coverage that includes emergency services, diagnostic services, preventive care, restorative services, oral surgery services, and medically necessary additional services.
- Ensuring that all policies and procedures comply with Medicaid Policy applicable to Contractors.
- Maintaining a network of qualified providers sufficient to meet the needs of Enrollees across specified geographic areas.

Period of Performance
The contract will be performed over a period determined by MDHHS based on enrollment cycles and program needs.

Place of Performance
Services will be provided throughout Michigan in designated regions as defined by MDHHS.

Bidder Requirements
Bidders must demonstrate capacity for network adequacy in one or more of ten designated regions in Michigan. They must also provide a Certificate of Authority confirming compliance with mandatory minimum requirements as specified in the Proposal Instructions.