Aetna Better Health says the Louisiana Department of Health and Hospitals did not follow the rules
A major insurance firm is continuing to protest its exclusion from the state's planned $2.2 billion privatization of coverage for more than 800,000 of the state 1.2 million Medicaid enrollees.
Louisiana Health and Hospitals Secretary Bruce GreensteinAetna Better Health Inc., a subsidiary of Aetna Inc., already lost an appeal with Louisiana Health and Hospitals Secretary Bruce Greenstein, who in July announced the selection of five firms slated to run the planned managed-care networks. Now the firm has asked Commissioner of Administration Paul Rainwater to throw out Greenstein's selections.
Among several claims, the insurer alleges in a letter to Rainwater that Greenstein's agency did not follow the parameters of its requests for proposals to participate in Gov. Bobby Jindal's signature health initiative. The company also notes that Greenstein rejected Aetna's appeal of the selection on Aug. 11, just a day after the company submitted "supplemental information" to its Aug. 8 appeal.
The firm also continues to argue that it is at a disadvantage on appeal because Greenstein's agency has withheld its scoring sheets and portions of the winning bids from three firms: Louisiana Healthcare Connections Inc., a subsidiary of Centene; AmeriHealth Mercy of Louisiana Inc.; and AmeriGroup Louisiana Inc. The state cites a pending legal dispute in which those firms have sought to block the release of what they claim is proprietary information.
Greenstein also has rejected a protest by Coventry Health of Louisiana Inc., a subsidiary of Coventry Health Care Inc. That firm has not said publicly whether it is filing a second appeal with Rainwater.
Contract negotiations with the selected firms have not yet begun. The Jindal administration estimates that the coordinated care networks will save the state-federal insurance program at least $135 million annually out of the $6.7 billion program.
A separate Medicaid contract dispute, meanwhile, appears to be over. ACS State Healthcare and Molina Medicaid Solutions will not pursue further appeals of a lucrative claims processing contract that the state health agency awarded to Greenstein's former employer, Client Network Services Inc. The companies' decision was first reported by The Advocate newspaper of Baton Rouge.
State Medicaid chief Jerry Phillips told The Advocate that the move to drop the protest will allow the state to begin contract negotiations with CNSI, which will be charged with administering the claims process for the Medicaid program. Contract negotiations must be completed within 30 days. It must be approved by the state Division of Administration and the federal Centers for Medicare and Medicaid Services.
Client Network Services Inc. submitted the lowest bid of the three companies that met the cut on technical scoring of proposals: $184.9 million over the 10-year pact. The contract is estimated to be worth about $300 million. The competing firms have argued that CNSI low-balled the cost, allowing the firm to win the contract despite having a lower technical score.
The contract was a flashpoint in Greenstein's rocky confirmation process during the spring legislative session. The secretary, who eventually won Senate confirmation in a divided vote, said he did not steer any advantages to CNSI, where he served as an executive from June 2005 to September 2006. He joined the Jindal administration last year.
The Associated Press contributed to this report. Bill Barrow can be reached at bbarrow@timespicayune.com or 504.826.3452.