Presbyterian Health Plan is taking on some 85,000 Medicaid patients in New Mexico from another insurance carrier, UnitedHealthcare, the Presbyterian president said Thursday.
The move comes as United has resolved its appeal in state District Court of a state decision to end its Medicaid managed care contract in the coming year. That leaves another care provider, Molina Healthcare, whose contract ends in January, with a pending challenge. Molina provides managed care to more than 217,000 Medicaid recipients..
Starting Sept. 1, United clients of Centennial Care 2.0, the state Medicaid program, will be served instead by Presbyterian, said Presbyterian Health Plan President Brandon Fryar.
In most cases, those patients will be able to keep their doctors, as well as the care coordinators the patients worked with at United, he said.
Presbyterian is also bringing about 340 United employees who worked directly with plan members into its fold.
“The members are seamlessly transitioning to another carrier,” Fryar said. “In the vast majority of cases, those members are able to maintain their relationship with their doctor and, to the extent we’re able to bring on employees, they’re able to retain their relationship with their care coordinator.”
The New Mexico Human Services Department in January announced it would not renew its contract for managed care with UnitedHealthcare and Molina Healthcare of New Mexico.
The state at the same time renewed five-year contracts for Centennial Care with Presbyterian Health Plan and Blue Cross Blue Shield of New Mexico. It added a contract with Western Sky Community Care, a subsidiary of publicly traded Centene Corp. Those contract renewals take effect Jan. 1.
Molina Healthcare, UnitedHealthcare and two other insurance carriers whose bids were rejected filed protests over the state decision to end or deny their contracts. Molina’s appeal is still pending, said Human Services spokeswoman Mary Elizabeth M. Robertson.
“The Human Services Department is pleased United Healthcare’s appeal of the Centennial Care 2.0 procurement process has been dismissed. We are working with Presbyterian Health Plan as they prepare for the transition of members from United Healthcare on Sept. 1,” Robertson stated in an email.
The 85,000 United plan members Presbyterian agreed to take on represent all United subscribers to Centennial Care, said Presbyterian spokeswoman Melanie Mozes. Presbyterian Health Plan, a subsidiary of the nonprofit Presbyterian Healthcare Services, is the largest manager of Medicaid services in the state. Centennial Care is the largest insurance plan in the state, with about 675,000 members.
Medicaid serves low-income clients, often working poor or disabled patients. Insurance companies are paid monthly for each insured patient based on age and health conditions, whether or not the patients receive services.
Former members of the UnitedHealthcare plan will have the option, like any other plan member, to select another carrier during the open enrollment period that opens Nov. 1, Fryar said.