Molina files protest over loss of Medicaid contract

At issue for both companies are hundreds of millions of dollars in managed care fees from Medicaid, the state-run health care program for low-income people.

The Human Services Department announced last month that Molina and UnitedHealthcare, both in the final year of a five-year contract, would no longer provide Medicaid managed care services beginning in 2019.

The department said it would retain Blue Cross Blue Shield of New Mexico and Presbyterian Health Plan as Medicaid managed-care providers and that it was contracting with a new provider, Western Sky Community Care, a subsidiary of Centene Corp. of St. Louis.

The contracting decisions by the Human Services Department followed a request for proposals from managed care organizations.

Molina has alleged the department failed to abide by state law and regulations in awarding the Medicaid contract. It also has said that a contract consultant hired by the agency had a conflict of interest with a winning bidder.

The department has said the contracting process was competitive and fair.

If the Human Services Department rejects the protests by Molina and UnitedHealthcare, the company can challenge that decision in court.

Last week, Molina filed a lawsuit asking a judge to block the department from entering into new Medicaid contracts pending the outcome of its protest.

Molina provides managed care to about 225,000 Medicaid recipients. Its New Mexico premium revenues, including Medicaid payments, totaled $1.3 billion in 2016, according to corporate filings.

Contact Thom Cole at 505-986-3022 or tcole@sfnewmexican.com.