State Medicaid contracts challenged again

The Ohio Medicaid system is being challenged again, this time by Aetna, which says it believes the state was wrong to terminate its contract earlier this month.

In a lawsuit filed in state court, Aetna said the Ohio Department of Job and Family Services (JFS) should reinstate its contract, which the department revoked after another insurer protested the contract-bidding protest, Columbia Business First reported.

Aetna held the contract to manage almost 2 million of Ohio's Medicaid recipients for only two short months. JFS reviewed bids from all insurers that submitted proposals to run the program after two insurers, Molina Healthcare and Centene, filed protests over the state's scoring of the proposals.

Upon reevaluation, JFS determined it wrongfully awarded points to insurers and, therefore, altered each insurer's score and rescinded its contract with Aetna, according to the Associated Press.

However, Aetna alleged in its lawsuit that Ohio, which found that it wrongfully awarded points to Aetna for operating managed-care plans in several states, improperly reduced its score based on the state's definition of whether it was fully at risk for claims expenses in other states, reported the St. Louis Business Journal.

Aetna's lawsuit also asks that that JFS stops signing contracts with other insurers.

To learn more:
- read the Columbus Business First article
- see the St. Louis Business Journal article
- check out the Associated Press article

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