Molina seeks injunction over NM Medicaid contracts

ALBUQUERQUE, N.M. — Molina Healthcare of New Mexico announced today that it is seeking an injunction against the New Mexico Human Services Department and the department’s secretary, Brent Earnest, after the company lost its contract to provide Medicaid services in the state.

Molina also plans to file a temporary restraining order against both parties, according to a statement.

Among Molina’s allegations are that the consultant hired by the state to help evaluate Medicaid proposals has a conflict of interest involving one of the successful bidders.

“The filing details the threats to 224,000 New Mexico residents dependent upon Medicaid, violations of the recent Centennial Care Medicaid procurement, and conflicts of interest regarding the contractor hired by the HSD to oversee the procurement,” the company wrote in the statement.

The state has not yet released a response.

Earlier this month, HSD announced the winners of the state’s five-year Medicaid contract known as Centennial Care 2.0, a list that did not include Molina. The loss of the contract will slash hundreds of millions of dollars from the Molina’s premium revenues, according to a recent Securities and Exchange Commission filing.

Molina claims:

— The procurement process excluded stakeholders such as the New Mexico Department of Health, the New Mexico Children, Youth and Families Department, and the Office of Superintendent of Insurance.

— HSD exhibited a pattern of changing the evaluation factors and/or added new ones that resulted in an unfair scoring process. This resulted in Molina’s technical score being reduced based on undisclosed factors, according to the company.

— A consultant, Mercer, was hired by HSD for drafting and reviewing the proposals as well as training or “coaching” HSD on how to evaluate the bids. Molina claims Mercer has a substantial multi-billion dollar contractual relationship with Envolve, a subsidiary of Centene Corporation, which is the parent of Western Sky, one of the Medicaid contract winners.

Molina also claimed that the loss of its Medicaid contract would lead to long wait times for “about 25,000 New Mexicans currently receiving behavioral health services.”

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Post Author : Claude Abbott

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