HealthChoices Procurement Again Mired in Litigation

For the past six years Pennsylvania has been trying to rebid its HealthChoices Medicaid managed care contracts but every time it does, the losing bidders sue the state and the procurement process grinds to a halt.

Three times since 2015 the state has issued requests for proposals from managed care companies and all three times at least one of the losing parties has responded to its defeat by filing a lawsuit.

This is happening, many believe, because the state’s Medicaid managed care contracts are so lucrative – a stark contrast with state Medicaid payments to providers, which are generally considered poor.

The matter is now in the state’s Commonwealth Court, and the stakes are great:  the contracts are for five years, with a possible option for another three.

The Philadelphia Inquirer has taken a look at the challenges that have prevented Pennsylvania from awarding new HealthChoices Medicaid managed care contracts in the article “Insurers want Pa.’s Medicaid business so badly they keep suing the state.”