State Of Washington Will Break Contract with Aetna – Violation of State Rules on Bidding Process
Posted Sep 18 2009 10:20pm
Due to problems with the bidding process, it will be done all over again. United HealthCare contested the bid process and you can see one group was very upset over the change in payment to become preferred provider, which is the case with many carriers, instead of being rewarded for being a preferred provider, they get less. Aetna felt they did no wrong and will resubmit and follow what ever guidelines set forth.
The state Health Care Authority says it is scrapping a contract with insurer Aetna, which had planned to take over administration of the popular Uniform Medical Plan for state employees in 2010.
The move had been expected to save the state unspecified millions of dollars, but the change was controversial and an administrative law judge threw out the contract last week, saying the bid process was defective and violated state rules. About 180,000 people are insured under the Uniform Medical Plan.
Insurers, led by United HealthCare, formally challenged the bid award. And Olympia-area psychotherapists, including family therapist Brian Kennedy, complained that they would see reimbursement rates cut nearly in half next year – from about $125 an hour to $66 in some cases – if they wanted to be in Aetna’s preferred network.
The judge found numerous defects in the health agency’s bidding process, including letting Aetna and other bidders change bid terms after bids were opened. United HealthCare also disputed that its bid had been judged not qualified. Its subsidiary, UMR/Harrington Health, already handles third-party administrative work for claims and customer service for the Uniform Medical Plan.