North Carolina State Treasurer Dale Folwell said Jan. 4 that the state would turn over management of its health plan for state employees to Aetna in 2025. The contract includes healthcare spending of more than $17.5 billion over five years.
BCBS North Carolina has held the contract for over 40 years. The payer filed a challenge to the state’s decision Jan. 12.
UMR was the third payer to bid for the state’s contract, which covers 740,000 state employees.
In its protest filing, UMR said North Carolina did not comply with request-for-proposal evaluation and scoring criteria in deciding Aetna had the best offer, according to the Winston-Salem Journal.
UMR said in its filing the state’s network cost analysis was “fundamentally and inherently flawed” because self-reported discount rates do not always reflect actual utilization.
In a statement, Mr. Folwell said the state will engage in a “factual, thoughtful and transparent review” of the contract decisions.
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