AP NEWS

Unsuccessful North Carolina Medicaid bidder appeals decision

February 26, 2019

RALEIGH, N.C. (AP) — An unsuccessful bidder for North Carolina’s new managed-care initiative to cover most Medicaid patients has appealed state government’s decision to leave it out.

The group “My Health by Health Providers” filed its formal protest Monday with the Department of Health and Human Services. The organization is composed of 12 local hospital systems and New Mexico-based insurer Presbyterian Healthcare Systems.

The organization blames DHHS for a “deeply flawed design and evaluation process” for leaving it out. The department awarded contracts this month to four conventional insurers and one physician partnership. The cumulative contract values could reach $6 billion annually.

A “My Health by Health Providers” news release says its systems provide 80 percent of the state’s Medicaid hospital care and fit the legislature’s desire to offer in-state provider coverage.