MM Summary: Anthem lost in 2 rounds of the recent KY RFP, but judge has ordered the state to award them a contract.
Clipped from: https://www.bizjournals.com/louisville/news/2020/11/23/years-long-litigation-over-medicaid-not-in-the-pub.html
Anthem Blue Cross and Blue Shield headquarters in Louisville.
File Photo
The judge presiding over the Kentucky Medicaid contracts controversy gave the eight parties involved a clear directive to resolve the matter promptly for the sake of the public interest in his latest order.
Franklin Circuit Court Judge Phillip Shepherd also approved the mediator that was proposed by the two state agencies and three of the Medicaid companies involved in the dispute.
“The Court reiterates both the importance of the mediation process and the importance of the [Medicaid] program to the public and to public health in the midst of a global pandemic,” Shepherd wrote in his order, dated Nov. 17. “Years of protracted litigation is not in the interest of the public or any party to this action.
“The Court is optimistic that the parties, in mediation, will craft a reasonable resolution to the issues in this case.”
Shepherd ordered mediation on Nov. 12.
The order also demands that the parties in the lawsuit set a date for mediation with John Van Winkle of Indianapolis-based Van Winkle-Baten Dispute Resolution as soon as possible and to freely share information among the parties.
The mediation seeks to resolve a lawsuit filed by Louisville-based Anthem Kentucky Managed Care Plan Inc. over allegations that state agencies — the Kentucky Cabinet for Health and Family Services and the Finance and Administration Cabinet — erred in how they awarded the state’s Medicaid contracts.
In Nov. 2019, then-Gov. Matt Bevin‘s administration awarded the five Medicaid contracts that start in 2021 to the following companies:
- Aetna Better Health of Kentucky Insurance Co.
- Humana Health Plan Inc.
- Molina Healthcare of Kentucky Inc.
- UnitedHealthcare of Kentucky Ltd.
- WellCare Health Insurance Company of Kentucky
However, because Bevin openly feuded with one of the losing Medicaid companies — Louisville-based Passport Health Plan — and because the award came after Bevin lost his election to now-Gov. Andy Beshear, Beshear restarted the RFP process at the beginning of 2020. However, that RFP process produced the same winners as the Bevin RFP. Anthem did not get a contract in either batch of awards.
Anthem failed in its administrative appeal with the state over the awards. It filed its lawsuit against the two state agencies and the five winning companies in September.
On Oct. 23, Shepherd ordered the state to include Anthem in the Medicaid program. The state has so far complied with the order despite its objections to the order. The other Medicaid companies state in court documents that they believe that Shepherd overstepped his bounds.