UCare sues to keep access to Minnesota public health plans
"We believe that despite the state's best intentions it acted improperly and contrary to law in deciding to exclude UCare," UCare's general counsel
UCare is seeking an emergency injunction in
Before the competitive bidding, UCare had the lion's share of the public health plan market. It managed 360,000 enrollees, all of whom will have to switch to different providers unless UCare overturns the state's decision. But the bid results released last month saw UCare fail to win access to a single
The loss was a huge blow to the
"Because of the significant reduction in membership and revenue, UCare will be forced to eliminate hundreds of jobs" if it loses these plans, the company's lawsuit claims.
Open enrollment under the new bidding is scheduled to start
State officials haven't released the exact figures showing why UCare fell short of other providers, chiefly Blue Plus,
Generally, cost made up 45 percent of the bid, while care quality made up the other 55 percent.
Before competitive bidding, all qualified health plans could contract with the state to manage public health plan enrollees. They would then compete for those enrollees.
UCare's lawsuit argues that the state's competitive bidding process was arbitrary, that its guidelines were more ambiguous and uncertain than state law allows for competitive bids, and that excluding UCare through the bidding process violated "statutory mandates for free choice."
It also claims that at least 47 different county boards passed resolutions recommending that DHS contract with UCare, and says the state released confidential UCare data to other plans as part of the bidding, which "potentially gave other plans a competitive advantage."
"UCare will suffer irreparable harm if DHS excludes UCare from the opportunity to provide health care services to eligible recipients of (public health plans)," the lawsuit concludes. "The public interest favors allowing UCare the opportunity to provide health care services to eligible (public plan) recipients... in the counties that recommended UCare."
On Tuesday, Gov.
"In my experience, almost everyone who doesn't get a positive result for themselves or their organization blames the process," Dayton said. "The bottom line is, this is a competitive bid process and they didn't measure up to the competition according to the criteria that were established in terms of price and in terms of quality of service, as relayed by the county workers and other factors."
Dayton also criticized state procurement law that prevents the bid scoring from being divulged "to UCare itself, much less to the press or the public" as an "absurd process." He said he was legally forbidden from revealing some of the reasons why UCare didn't win any county bids.
By seeking statewide competitive bids for the first time, the state projects it will save taxpayers
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