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Dayton
Business Journal...
Aetna
sues
Ohio over Medicaid contracts
by Rick
Rouan, Web coordinator
Friday,
June 22, 2012
Aetna Inc.
has asked a Franklin County Common Pleas Court to reinstate its Ohio
Medicaid
contract in a lawsuit filed Wednesday.
Aetna sued
the Ohio Department of Job and Family Services, arguing its contract
was
rescinded after its score was improperly reduced based on the state’s
definition of whether it was fully at risk for claims expenses in other
states.
The Hartford, Conn.-based company wanted to file an administrative
protest over
the state’s decision to yank its provisional contract but the
department said
the protest period had ended. Job and Family Services had revised its
original
contract awards after several companies that initially lost out
protested the
decisions.
In its
lawsuit, Aetna is asking the court to stop the state from signing
contracts
with other providers until the lawsuit is resolved and to force the
department
to reinstate Aetna’s contract award. ODJFS Spokesman Ben Johnson said
the
department does not comment on pending litigation.
The state
is contracting with private managed-care companies to provide coverage
for
disabled and low-income Medicaid enrollees. In April, Aetna (NYSE:AET)
was one
of five plans to which the department offered provisional contracts,
but it
reversed that decision when losing applicants protested the decision,
pointing
in part to how it scored Aetna’s Medicaid work in other states. On June
7, the
state said it was yanking offers to Aetna and Meridian Health Plan, a
for-profit Medicaid specialist, and instead would give contracts to
Long Beach,
Calif.-based Molina Healthcare Inc. (NYSE:MOH) and St. Louis-based
Centene
Corp. (NYSE:CNC).
Meridian
also submitted a protest letter but was rebuffed by the state.
The three other plans to receive contracts
— Dayton-based CareSource
,
Minneapolis-based UnitedHealth Group Inc.
(NYSE:UNH) and Toledo-based Paramount
Health Care — were unchanged.
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