Mississippi Medicaid Plays Musical Chairs With MCOs, Trades UHC for CareSource Affiliate

 

by Lauren Flynn Kelly   Despite a challenge earlier this year to its longstanding pact with Mississippi Medicaid, Centene Corp. on Aug. 10 said its Magnolia Health Plan subsidiary was selected to continue serving the Mississippi Coordinated Access Network (MississippiCAN) and the Mississippi Children’s Health Insurance Program (CHIP). Meanwhile, the state’s Division of Medicaid (DOM) unveiled its intent to award new four-year contracts to two other insurers, including new entrant and CareSource affiliate TrueCare, which will bump leading managed care organization UnitedHealthcare out of the market.  Centene’s win follows major settlement  Centene over the past year has reached multiple settlements with states regarding its handling of Medicaid pharmacy benefits. In June 2021, the health care giant agreed to pay $55.5 million to Mississippi after a 2019 investigation by the Office of the State Auditor concluded Centene’s pharmacy benefit manager was overbilling the state.   In February, Mississippi state Rep. Becky Currie, a Republican, introduced an amendment that would have prevented the state from doing further business with Centene and required the state to contract with a nonprofit entity to provide Medicaid services. The amended bill (H.B. 658) passed the House but ultimately died in conference.   Mississippi remains one of 12 states that have not expanded Medicaid under the Affordable Care Act, despite ballot initiative efforts. More than 823,000 Mississippians are enrolled in Medicaid, and more than half are in managed care.  United mulls its next move  UnitedHealthcare is the largest Medicaid MCO in Mississippi, with just over 173,500 lives, according to AIS’s Directory of Health Plans. According to the DOM’s website, five prospective organizations submitted offers to serve MississippiCAN and Mississippi CHIP.  TrueCare received the highest overall score in the bidding process. Ohio-based nonprofit insurer CareSource in December 2021 said it formed an alliance with TrueCare to serve Mississippi Medicaid members through a “unique structure that leverages CareSource’s 30+ years of Medicaid managed health plan experience and strength as a national leader in quality and operational excellence.”  DOM noted that its Aug. 10 notice of intent does not complete the procurement process and MCOs may file award protests. A UnitedHealthcare spokesperson at press time said the company is still weighing its options.  “We are honored to serve more than 450,000 people in our commercial, Medicare, Medicaid and Dual Special Needs plans in Mississippi and look forward to working with the State on future opportunities to provide access to high-quality health care,” said the spokesperson in an email to AIS Health. “Currently, we are reviewing the State’s MississippiCAN and CHIP award decision to determine next steps.”

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