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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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