A Pennsylvania Court has ruled the state’s Department of Human Services violated procurement rules when an official met with top executives of a company bidding for a share of its Medicaid service contracts.
The Commonwealth Court’s decision is in response to UnitedHealth Group’s challenge of the award of $12 billion in contracts to Centene Corp. UHG alleged the state’s selection of Centene was influenced by a December 2016 meeting between the health department’s deputy director and two Centene executives.
Because of that, UnitedHealth officials claim, they were ultimately denied a slice of the Medicaid pie for physical health services in Pennsylvania.
The Philadelphia Inquirer said it appears the state will have to start its selection of Medicaid managed care contractors over again, citing Tuesday’s decision.
The court said it is “limited to canceling the solicitation or award and declaring void any resulting contract” if it finds procurement law was violated.
The Human Services Department did not respond to the newspaper’s request for comment.
Pennsylvania is not the only state to face ethics questions in its transition to privatized Medicaid.
In New Mexico, Molina has filed two protests against the state’s decision to remove it from the Medicaid program, citing a beneficial relationship between a consultant used in the bidding process and one of the contractors ultimately selected.
And in Iowa, one of the original three contractors selected walked away from its deal early, blaming the state for underestimating costs. Complaints about the care provided (and denied) under the privatized system run by the remaining two contractors more than doubled in their second full year of operation.