HealthChoices—Pennsylvania’s managed care program for physical health, which includes our […]
PA Commonwealth Court overturns HealthChoices Contracts
April 26, 2018
HealthChoices—Pennsylvania’s managed care program for physical health, which includes our pediatrics practice—announced its newly rebid contracts in early 2017. For the past several years, this rebid process has been fraught with issues due to Managed Care Organizations’ (MCOs) protests. The newly announced contracts proved to be no different, as United submitted a contract bid protest shortly after this announcement.
United submitted this protest due to their belief that the state made an improper contract decision. Recently, Pennsylvania’s Commonwealth Court took up this protest and ruled in favor of United. The Court found that DHS met with MCOs during the black out period, thus ruling in favor of United’s protest.
DHS has not yet announced its next steps, but it is possible that the department will have to rebid all of HealthChoices’s contracts again. Because HealthChoices represents over $12 billion in contracts for potential MCOs, this ruling has created unprecedented waves in the state’s healthcare community. GAO will continue to monitor the outcomes of this ruling and will update the pediatric practice as more information becomes available.