Molina Healthcare sues New Mexico after losing Medicaid contract: 3 things to know

Molina Healthcare of New Mexico filed a lawsuit against the New Mexico Human Services Department over a lost bid to manage the state's Medicaid program, the Santa Fe New Mexican reports.

Here are three things to know about the contract.

1. In its lawsuit, filed in the First Judicial District Court in Santa Fe, N.M., Molina alleges the state health department used a consultant with a possible conflict of interest during the application process. Molina claimed the consultant has a multibillion-dollar contract with a sister company of Western Sky Community Care, which won a contract to manage some of New Mexico's Medicaid recipients.

2. Molina also argues the health department unreasonably sped up its contracting process and changed evaluation factors, according to the Santa Fe New Mexican.

3. New Mexico's multibillion-dollar Medicaid program covers 850,000-plus beneficiaries. New Mexico chose Blue Cross Blue Shield of New Mexico, Presbyterian Health Plan and Western Sky Community Care to manage Medicaid beneficiaries. UnitedHealthcare and Molina, both in the last year of their five-year contracts to manage the program, lost bids to retain their roles beginning in 2019.

More articles on payer issues:
Top 6 BCBS plans see Q3 profit margins improve
DOJ requests information on $69B CVS Health-Aetna deal: 3 things to know
25k removed from Indiana Medicaid for not paying premiums: 5 things to know

Copyright © 2022 Becker's Healthcare. All Rights Reserved. Privacy Policy. Cookie Policy. Linking and Reprinting Policy.


Featured Podcast

Featured Webinars

Featured Whitepapers

Top 40 articles from the past 6 months