Ohio Court Supports Aetna Motion To Prohibit State From Moving Forward With Medicaid Managed Care Awards
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COLUMBUS, Ohio, June 26, 2012 — An Ohio court today granted a request for a temporary restraining order (TRO) filed by Aetna Better Health Inc., an Aetna (NYSE: AET) Medicaid company, to stop the State of Ohio from moving forward with the Medicaid managed care awards announced on June 7, 2012. Aetna’s request for the TRO was granted after Aetna raised significant legal issues regarding the decision by the Ohio Department of Job and Family Services’ (ODJFS) to arbitrarily change the terms of its Medicaid awards and actions by the ODJFS and its staff that denied due process of law. Aetna originally was awarded a Medicaid contract; however ODJFS later canceled that contract, deciding to change the contract award criteria after the awards were made. The Franklin County Court of Common Pleas acted today to grant the TRO and scheduled a preliminary injunction hearing on the case filed by Aetna for July 23, 2012. Aetna had no choice but to seek judicial review after being informed by ODJFS that it would not allow Aetna the right to submit a timely protest of the state’s latest contract awards. Aetna noted that ODJFS had considered an untimely request from a previously unsuccessful bidder after the protest period for the original awards had expired. “The people of Ohio deserve a careful consideration of the issues surrounding the expenditure of billions of dollars of taxpayer funds,” said Jan Stallmeyer, senior vice president, Central Region, for Aetna Medicaid. “We believe that it is only prudent that ODJFS take the time to examine the serious questions that have been raised about the manner in which these contracts were awarded, then re-awarded to other plans. Given the size of this contract and the importance of these healthcare services to hundreds of thousands of Ohio citizens, many of whom are in the most vulnerable segments of society, it is in everyone’s best interest to have a thorough and transparent review.” Aetna had filed a protest letter on June 14, 2012 outlining significant flaws in the contract award process, including the decision by the ODJFS to retroactively change the definition of certain requirements outlined in its Request For Application (RFA). In addition, Aetna learned that representatives of ODJFS had engaged in previously undisclosed written communications regarding Aetna with another bidder after the initial protest period had closed. ODJFS did not provide Aetna with the opportunity to respond to the misleading information provided in these undisclosed communications, which is a violation of the express terms of the RFA and state law. With 25 years of managed Medicaid experience, Aetna Medicaid owns and operates fully managed Medicaid plans for states and uses various models for doing so, fitting the model to match the state's needs. The company most frequently uses models that are either fully-owned or fully-managed, in which Aetna assumes the operational and management oversight of the health plan, including the hiring of all health plan employees and the provision of all health plan operational systems. About Aetna |
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