MM Curator summary
The MCO seems to have reached the end of the appeals process.
The article below has been highlighted and summarized by our research team. It is provided here for member convenience as part of our Curator service.
Aetna Better Health of North Carolina’s lawsuit protesting its loss of a bid to operate a Medicaid managed care prepaid service is barred because the company didn’t comply with rules for judicially appealing the decision, a state court said Tuesday.
Noncompliance with a state law that sets out mandatory provisions for appealing administrative agency decisions requires the appeal’s dismissal, the North Carolina Court of Appeals said.
North Carolina is in the process of transitioning its Medicaid plan from a fee-for-service model to a managed care model. Aetna unsuccessfully bid for a prepaid health contract and protested its loss through …