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KY MCO lawsuits continue, with latest development being court-ordered mediation.
Clipped from: https://www.bizjournals.com/louisville/news/2020/11/12/kentucky-medicaid-dispute-headed-toward-mediation.html
Getty Images / Maren Winter / EyeEm
The legal dispute surrounding the state’s Medicaid awards is headed to mediation.
On Thursday, Franklin County Circuit Judge Phillip Shepherd ordered the counsels for all parties involved in a lawsuit filed by Anthem Kentucky Managed Care Plan Inc. to seek approval to engage in mediation, select a mediator and choose days for mediation — all within the next 30 days.
Shepherd wrote that he would assign a mediator if the parties failed to agree on mediation or the selection of a mediator. He also expects a status report from the parties by the close of business Friday, Nov. 13.
In September, Anthem sued the state and the five Medicaid companies it awarded big-dollar Medicaid contracts to, alleging the state erred in the the awards process. Specifically, Anthem alleged in its suit that the state made scoring errors and failed to eliminate a bidder for the Medicaid contracts that inappropriately hired a former state official.
Anthem’s suit followed a failed administrative appeal over the contract awards.
In November 2019, the administration of then-Gov. Matt Bevin announced the five winners of an request for proposals for the Medicaid contracts after Bevin lost the election to now Gov. Andy Beshear, who rescinded the contracts in December 2019 and announced a new RFP process.
Ultimately, the Beshear administration announced the same RFP winners as the Bevin administration had.
Here are the companies that were twice awarded contracts by two different administrations. They are also named as defendants in Anthem’s lawsuit:
- Aetna Better Health of Kentucky
- Humana Health Plan Inc.
- WellCare Health Insurance of Kentucky
- Molina Healthcare of Kentucky
- UnitedHealthcare Community Plan of Kentucky
Shepherd also wrote in his Thursday order that he would consider a motion from UnitedHealthcare asking the court to assign it the members of Molina Healthcare and eliminate Molina from the Medicaid program and reverse a previous order that would allow Anthem to continue participating in the Medicaid program. UnitedHealthcare made that motion Nov. 2.
Timeline of court proceedings
On Oct. 23, Shepherd ordered the state to allow Anthem to continue in the Medicaid program, making it a sixth Medicaid company.
The managed-care organizations that won contracts and the state agencies claim in court documents that the judge overstepped his bounds. However, the state agencies complied with the order in an attempt to reduce disruption to the members in the Medicaid program.