Centene Deal with Ohio Moves Forward

Ohio to move forward on Medicaid deal with Centene

August 19, 2012 11:38 am  •  ASSOCIATED PRESS

COLUMBUS, OHIO • A judge dismissed a lawsuit Thursday that had blocked Ohio from moving forward with certain Medicaid contracts, including one with Clayton-based Centene Corp., clearing the way for the state to proceed with the tentative agreements it has with five health plans, state officials said.

Aetna Better Health of Ohio had sued the Ohio Department of Job and Family Services in a dispute over the scoring of the contract applications. But in a ruling from the bench, a Franklin County Common Pleas judge dismissed the case during a hearing on the issue, Kasich administration officials said. The judge’s office did not immediately respond to a call for comment.

The eventual contract winners will provide health care services to more than 1.6 million poor and disabled people, or roughly two-thirds of the state’s Medicaid population. The contracts provide billions in government work to the companies.

State officials had tentatively selected Aetna for a contract in April and then revoked the decision in June. Aetna claimed the state retroactively changed the definition of certain requirements in its request for contract applications, and the company wanted its contract reinstated.

An Aetna spokesman on Thursday wouldn’t address whether the company planned to appeal the court decision, but said it was disappointed.

“Aetna has a substantial presence in the state and we remain committed to doing business in Ohio,” said spokesman Scot Roskelley.

Ohio health officials praised the lawsuit’s dismissal.

“The Court’s decision confirms what we’ve believed all along: we reached the right decision and we did it the right way,” Ohio Medicaid Director John McCarthy said in a joint written statement with Greg Moody, director of the Governor’s Office of Health Transformation.

The health plans chosen were said to be the highest-scoring applicants in the state’s Medicaid contract process. But five of six companies that lost bids for the contracts filed formal protests with Ohio officials in April, claiming flawed and inaccurate scoring.

A state review of the contract applications changed how points were scored. And on June 7, state officials said Aetna Better Health of Ohio and Meridian Health Plan of Ohio would no longer get the contracts.

Instead, Molina Healthcare of Ohio Inc., a subsidiary of Molina Healthcare Inc., and Buckeye Community Health Plan, a subsidiary of Centene, were picked.

Ohio has also selected CareSource, Paramount Advantage and United Healthcare Community Plan of Ohio.

The state review found that Meridian should have been disqualified because it didn’t have a necessary health-insuring corporation license or an application pending for one at the time of its bid. And Aetna lost many points because the state said the company did not provide evidence of full liability for certain plans with other states.

The contract awards to the five plans remain preliminary. The managed care organizations must first pass an assessment, in which they must prove that they will be ready and able to provide care when enrollment begins in January.

State officials said they were still reviewing whether the timeline for enrollment could change because of the lawsuit.