Thursday, August 16th, 2018 at
3:40pm
ALBUQUERQUE, N.M. —
Presbyterian Health Plan will acquire 85,000 Medicaid members insured under
UnitedHealthcare of New Mexico as well as 340 United employees in a deal both
companies confirmed Thursday.
United also confirmed to the
Journal that its appeal against the New Mexico Human Services Department was
recently dismissed. The company filed the appeal earlier this year after it
failed to secure a Centennial Care 2.0 Medicaid contract through the state’s
procurement process.
A Human Services Department
spokeswoman said in an email the state was “pleased” by the dismissal and is
working with Presbyterian on the transition.
The United members and
employees will transition to Presbyterian on Sept. 1. United said in a
statement it is “committed to ensuring a seamless transition.”
Brandon Fryar, president of
Presbyterian Health Plan, declined to disclose the financial terms involved but
said the companies had long discussed the possibility of such an arrangement.
“This is about taking care
of New Mexicans, and in the vast majority of cases, we will be able to preserve
the continuity of care with their providers,” said Fryar. “It’s also about
extending 340 people gap-free employment.”
The 85,000 United members
impacted by the transition were sent a letter Thursday, according to Fryar. He
said that population does not include members who are insured by both Medicaid
and Medicare through United, who will remain with the company.
New Mexicans enrolled
through United’s Dual Complete Plan, Medicare and commercial plans will
continue to have their insurance administered through United, according to the
company.
United said the 340
employees represents “the majority” of those employed by the company in New
Mexico.
Fryar said Presbyterian
currently insures 217,000 New Mexicans with Medicaid. Those who transition to
Presbyterian from United will still be able to participate in the open
enrollment period, he said. That period begins in October of this year and
extends through the end of November.
Earlier this year, the Human
Services Department awarded Centennial Care 2.0 contracts to incumbents
Presbyterian and Blue Cross Blue Shield of New Mexico as well as Western Sky
Community Care.
According to the state,
members impacted by the transition can contact United before Sept. 1 at
877-236-0826, or Presbyterian after that date at 505-923-8669 or 877-614-7447.
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