HSD RESPONDS TO CRITICISMS

Human Services Department defending its method of selecting Medicaid insurers.

The state Human Services Department is defending its method of selecting Medicaid insurers after Molina Healthcare of New Mexico, a failed bidder, claimed the process was unfair.

Molina this week filed court documents seeking to ban Western Sky Community Care, one of the companies that won a contract, from providing Medicaid insurance in the state, according to legal filings obtained by the Journal.

HSD selected Western Sky, a subsidiary of the St. Louis, Mo.-based Centene Corp., as one of three providers under a five-year Medicaid contract.

“New Mexico’s HSD has seen no such lawsuit as of today,” said a spokeswoman in a statement Thursday. “This procurement process was competitive and fair. Molina Healthcare has an opportunity to protest following the end of the procurement period. HSD is committed to providing the highest quality services to the people of New Mexico dependent on Medicaid.”

Molina stated in the filings that it will submit a protest to the state by Feb. 5. It is seeking an injunction against the department and its secretary, Brent Earnest, as well as a restraining order against both parties. The company alleges the state oversaw a “flawed” procurement process for the Medicaid contracts, and that a consultant hired by HSD to help evaluate proposals — a company called Mercer — had a conflict of interest involving Centene.

Molina also claims HSD changed or added evaluation factors “up to 30 times” during the bid process, and then reduced Molina’s score based on these undisclosed factors.

The filings show Molina is seeking to prevent HSD from continuing the procurement process. It also is requesting that Western Sky or any subsidiary of Centene be barred from providing Medicaid insurance in New Mexico for “a period allowed by law,” and that a Medicaid contract be awarded to Molina.

Centene has not yet responded to a request for comment. Mercer said it had no comment.

Besides Western Sky, contracts were also awarded to Blue Cross Blue Shield of New Mexico and Presbyterian Health Plan. Molina and United Healthcare, both of which had previously administered Medicaid, were rejected.

The loss of Molina’s Medicaid contract will slash hundreds of millions of dollars from the company’s premium revenues, according to a recent Securities and Exchange Commission filing. In the court filings this week, Molina stated that “HSD’s decision to end Molina’s Medicaid managed care contract places at risk all of Molina’s operations in New Mexico, including the Exchange and Medicare lines of business.”