- Centene and Aetna have filed protests to the state of Louisiana after losing a contract to provide benefits to Medicaid beneficiaries in 2020.
- In its protest letter, Centene, which does business in the state as Louisiana Healthcare Connections, alleges the state's process was "tainted by multiple conflicts of interest from the start."
- Aetna is skeptical of the results given the strength of its bid especially after reviewing competing bids, the company told Healthcare Dive.
At stake for Centene and Aetna is billions of dollars and the ability to continue to serve thousands of Medicaid enrollees in Louisiana.
In fiscal year 2018, Louisiana's Medicaid program paid $7.6 billion to five managed care organizations. "These payments covered more than 1.7 million Medicaid enrollees," the Louisiana Department of Health said.
Aetna is alleging that the health department used a "subjective, biased and arbitrary scoring methodology" when awarding the contracts, which the health insurer alleges is against Louisiana's procurement law.
Aetna also argued that a department consultant warned LDH that its scoring methodology had not been used in any other state.
Centene argued that while it was engaged in a policy dispute with individuals within the department, those same individuals were tasked with evaluating contract awards.
Aetna wants the results thrown out and for the RFP to be reissued using "industry best practices," according to the protest letter sent to the state procurement office.
Centene wants the awards vacated and for the agency to either redo the RFP or reevaluate the proposals objectively.
The 2020 contracts were awarded to AmeriHealth Caritas Louisiana, Community Care Health Plan of Louisiana (Healthy Blue), Humana Health Benefit Plan of Louisiana and United Healthcare Community Plan.
Both Centene and Aetna argued in their protests that Humana failed to provide accurate information, among other claims.