A managed care organization that stands to lose thousands of public health insurance enrollees across 10 rural counties sued the state on Monday over competitive bidding results announced this summer.
In July, the state Department of Human Services (DHS) announced it would drop South Country Health Alliance as an option next year in 10 of 11 counties where the governmental group currently manages care for enrollees in public health insurance programs.
South Country is challenging the decision through a state mediation process, and says it will have a better chance of succeeding with access to the state’s scoring of bid documents.
A mediation hearing is scheduled for Sept. 16.
Last month, another managed care organization in the public programs — Minneapolis-based UCare — sued the state over the bidding results, asking the court to establish the HMO as an option for Medicaid and MinnesotaCare enrollees in certain counties.
“DHS has indicated that it would like to produce the data to [South Country], but it believes the disclosure would violate the Minnesota Government Data Practices Act,” the group said in a lawsuit filed in Ramsey County District Court. “Moreover, DHS has indicated it will provide the data to the mediation panel, meaning the mediators and DHS will be able to review and discuss this information during the proceeding while [South Country] will not.”
South Country is a joint-powers entity established by 11 Minnesota counties to manage care for public health insurance enrollees. As of August, the governmental group had about 32,000 enrollees.
While South Country is a governmental agency and UCare is a private nonprofit HMO, they both serve as managed care organizations in the state’s public health insurance programs.
The two groups were losers in the most recent round of competitive bidding. DHS has not released details about how it scored bids because contracts haven’t been finalized.
In a statement Monday about the South Country lawsuit, DHS said it has “provided all of the information we legally can without a court order instructing us to release additional information. The bids and scores will be public once the contracts are final.”
UCare has about 369,000 enrollees in the state public programs. Earlier this month, a Ramsey County judge declined to issue a temporary injunction that would have maintained the HMO as an option.