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Dayton Business Journal...
Insurers file protest after shut out from Ohio Medicaid
by Carrie Ghose
Tuesday, April 17, 2012

Five of the six private health plans that did not win new statewide contracts with Ohio Medicaid filed formal protests by Monday’s deadline.

A common theme in the protest letters is that the state’s scoring methods did not meet objectives in bidding documents that the overhaul of the Medicaid program should improve the coordination of care for 1.7 million recipients and improve health. Four of the letters use the word “arbitrary.” Virginia Beach, Va.-based Amerigroup Corp. argues the inconsistencies are “not errors of judgment but are errors in fact.” Tampa, Fla. WellCare Health Plans Inc. said different standards were applied to different applicants.

Molina Healthcare Inc., of Long Beach, Calif., which had been Ohio Medicaid’s second-largest plan, and Bethesda, Md.-based Coventry Health Care Inc., both objected to scores they submitted for Medicaid experience in other states that were omitted.

Some questioned the high scores among the five winning bidders. Buckeye Community Health Plan, the Columbus subsidiary of St. Louis-based Centene Corp., asked for disqualification based on what it called inaccurate submissions by Hartford, Conn.-based Aetna, Dayton-based CareSource and Meridian Health Plan of Detroit.

CareSource, one of Dayton’s largest companies, has the potential to increase its Medicaid recipient membership base.

Only Anthem Blue Cross and Blue Shield in Ohio, which was not chosen in its bid to return to the program after exiting in 2008, did not protest. The WellPoint Inc. subsidiary remains the state’s largest insurer, with commercial and private Medicare Advantage coverage.

The April 6 announcement by the Ohio Department of Job and Family Services caused precipitous drops in the stock prices of several losing bidders. But an April 12 report from managed care analysts at Barclays Capital    Inc. cautioned that the Ohio effect may be temporary and might represent a good opportunity to buy those stocks. Upon reviewing the scoring sheets, Barclays noted “considerable inconsistencies” among the different bidders, to a greater degree than the firm is used to seeing even in large complex programs.

“While contract protests have not historically been successful, we would not rule that out in this case, particularly after seeing these results,” the report said.

The other winning bidders were Minneapolis-based UnitedHealth Group Inc. and Paramount Health Care, owned by Toledo hospital system ProMedica.

Read this and other articles at the Dayton Business Journal


 
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