It's been a rough August in Medicaid managed care in various
ways, as is perhaps best illustrated by two publicly traded giants in the
field: CVS Health Corp.'s Aetna Medicaid unit and Centene Corp. Both Aetna
Better Health of Louisiana and Centene's Louisiana Healthcare Connections
recently learned they lost out on Louisiana's Medicaid plan contracts for 2020.
The Louisiana Dept. of Health on Aug. 5 announced its intent to
contract with four Medicaid managed care organizations — AmeriHealth Caritas
Louisiana, Community Care Health Plan of Louisiana (Healthy Blue), Humana
Health Benefit Plan of Louisiana, and UnitedHealthcare Community Plan of
Louisiana — following a state bid process that began in February.
Out of 1,500 maximum points for the MCOs' RFP, Centene's
subsidiary scored the lowest at 621 points, followed by Aetna's 669 points,
while the four winning plan bidders scored in the 700s or 800s, according to
the state health agency's summary score sheet.
Timing remains an issue as potential legal disputes could
further complicate matters. State officials said Louisiana expects to execute
the Medicaid contracts on or about Aug. 23. Open enrollment is slated to run
from Oct. 15 through Nov. 30, when members can select new plans, but state
officials acknowledged the implementation timeline could stall in the event of
a protest.
In fact, Aetna and Centene filed protests with the state on Aug.
19 charging that the bidding process was tainted.
"We were shocked and confused by the state's decision, and
very concerned for our 450,000 members," a Louisiana Healthcare
Connections spokesperson told AIS Health on Aug. 15.
"Transitioning a half-million members within 45 days is a
massive undertaking, and we are deeply concerned about that transition leading
to disruptions in care for our members," the spokesperson added.
From Health Plan Weekly
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