Aetna's $7B Medicaid contract challenge dismissed

Aetna has lost its lawsuit protesting Ohio Medicaid's decision to rescind its contract and instead award other insurers with the chance to manage about $7 billion worth of Medicaid business.

A state court dismissed the lawsuit Thursday, thereby upholding the existing contacts and allowing Ohio to move forward with its plans to privatize Medicaid, reported The Columbus Dispatch.

"I've seen no evidence in this case in all the filings, all the testimony, all the evidence of any abuse of discretion on the part of the state of Ohio," Judge Richard Sheward said. "Quite the contrary, I think Aetna came up with a new interpretation as to what full risk is and I definitely did not accept that."

Aetna sued the Ohio Department of Job and Family Services (JFS), claiming the department wrongfully terminated its contract that it held for only two months. After originally granting Aetna a Medicaid contract, two insurers protested the department's scoring of the proposals, leading JFS to revoke Aetna's contract, according to the Associated Press.

Despite the court loss, Aetna could still win a contract to administer an Ohio Medicaid plan for chronically ill patients. The state is currently considering proposals for the contract, which could be worth up to $5 billion, and may announce its decision in the next few weeks, Columbus Business First reported.

Greg Moody, director of the Governor's Office of Health Transformation, said the two Medicaid contracts are "two completely separate processes," and the state isn't "going to let spilled milk in one process affect the other."

To learn more:
- read the Columbus Dispatch article
- see the Associated Press article
- check out the Columbus Business First article

Suggested Articles

States want to try value-based payment models for drug costs, but there are plenty of barriers to implementation, according to a new report.

Oncology centers blasted a Trump administration proposal to bundle Medicare payments for radiation therapy.

At least six states are creating their own health insurance marketplaces or seriously considering doing so.