- Four companies that lost bids for long-term care contracts for Pennsylvania Medicaid beneficiaries are challenging the state's awards, the Pennsylvania Department of Human Services said earlier this week.
- The stakes for the contracts are high, given their total worth estimated at $5.4 billion in annual revenue.
- The contracts are for Pennsylvania's new Community HealthChoices program, which aims to revamp coordination and support for the state's older and disabled population of about 420,000.
The incident is an example of the fairly common practice of challenging lucrative contract awards, which can result in re-bidding.
After 14 companies submitted bids and waited for delayed decisions, those that won were AmeriHealth Caritas of Independence Blue Cross; Pennsylvania Health and Wellness of Centene; and UPMC for You.
The companies that lost bids and are protesting those awards are Aetna Better Health, Molina Healthcare of Pennsylvania, WellCare of Pennsylvania, and Gateway Health Plan of Highmark Inc. and Mercy Health System of Southeastern Pennsylvania. Another managed-care company, Health Partners Plans Inc., was still deciding whether to protest.
As noted by Philly.com, Aetna protested another Pennsylvania contract award this year for the acute-care side of Medicaid, which resulted in the state re-bidding the contract, noting the company won a contract for just one of Pennsylvania's five zones.
The current challenges have caused current contract negotiations to be stayed, which could delay the implementation of the Community HealthChoices program, which is currently slated to begin its three-phase rollout July 1, 2017. The program has already been pushed back from Jan. 1, 2017.
The state intends for the CHC program to assist its older and disabled population in coordinating care and resources so they can remain in their homes rather than facilities and maintain a higher quality of life.