Pres to acquire 85K members from United

Medicaid coverage to transition to new carrier starting Sept. 1

Presbyterian Health Plan will acquire 85,000 Medicaid members insured under UnitedHealthcare of New Mexico as well as 340 United employees in a deal both companies confirmed Thursday.

United also confirmed to the Journal that its appeal against the New Mexico Human Services Department was recently dismissed. The company filed the appeal earlier this year after it failed to secure a Centennial Care 2.0 Medicaid contract through the state’s procurement process.

A Human Services Department spokeswoman said in an email the state was “pleased” by the dismissal and is working with Presbyterian on the transition.

The United members and employees will transition to Presbyterian on Sept. 1. United said in a statement it is “committed to ensuring a seamless transition.”

Brandon Fryar, president of Presbyterian Health Plan, declined to disclose the financial terms involved but said the companies had long discussed the possibility of such an arrangement.

“This is about taking care of New Mexicans, and in the vast majority of cases, we will be able to preserve the continuity of care with their providers,” Fryar said. “It’s also about extending 340 people gap-free employment.”

The 85,000 United members impacted by the transition were sent a letter Thursday, according to Fryar. He said that population does not include members who are insured by both Medicaid and Medicare through United, who will remain with the company.

New Mexicans enrolled through United’s Dual Complete Plan, Medicare and commercial plans will continue to have their insurance administered through United, according to the company.

United said the 340 employees represents “the majority” of those employed by the company in New Mexico.

Fryar said Presbyterian currently insures 217,000 New Mexicans with Medicaid. Those who transition to Presbyterian from United will still be able to participate in the open enrollment period, he said. That period begins in October of this year and extends through the end of November.

Earlier this year, the Human Services Department awarded Centennial Care 2.0 contracts to incumbents Presbyterian and Blue Cross Blue Shield of New Mexico as well as Western Sky Community Care.

According to the state, members impacted by the transition can contact United before Sept. 1 at 877236-0826, or Presbyterian after that date at 505-9238669 or 877-614-7447.