Four payers were competing to run the state’s more than $3 billion Medicaid program, according to the release. Blue Cross Blue Shield of Rhode Island and Tufts Health Plan were disqualified because they did not meet the minimum required score on the technical portion of their proposals. Insurers were required to score at least 85 points out of a possible 100 on their technical proposals. BCBS scored 63.22 and Tufts scored 54.38.
A BCBS spokesperson told the Current that the payer is reviewing the results of the procurement process.
“While we work to better understand the state’s assessment, we remain committed to collaborating with the Executive Office of Health and Human Services and to building healthier lives and communities in Rhode Island,” the spokesperson told the news outlet.
Tufts has managed the state’s Medicaid program along with UnitedHealthcare and Neighborhood since 2016, according to the report. A spokesperson for Tufts told the news outlet they “strongly believe that Tufts Health Plan continues to be the plan best suited to meet the unique health needs and address the diverse challenges of the Medicaid beneficiaries across Rhode Island.” The spokesperson added that Tufts remains committed to high quality health coverage until the end of their current contract.
The new contracts are set to go into effect on July 1, 2025, according to the report. The contracts run through June 30, 2030, with the option for a five-year renewal.
