A Department of Community Health statement, from new Commissioner Clyde Reese, said a review found that a project for the State Health Benefit Plan (SHBP) to obtain a “regional vendor,’’ begun in May, was “not properly inclusive.’’
The agency will ask the state attorney general’s office for guidance and will develop “an alternative approach to solicit responses from vendors to provide health plan options within specified regions of the state,’’ Reese said in a statement.
The statement followed an Atlanta Journal Constitution report Thursday on a protest by UnitedHealthcare that alleged that Community Health held a secret bid that kept the Minnesota-based company from competing for SHBP business.
Community Health said Thursday that the main SHBP project for a statewide benefits vendor, begun in February, will continue under the current contracting process. The agency Wednesday released a “notice of intent to award” that contract to Blue Cross and Blue Shield of Georgia, the AJC reported.
The agency allows 10 days for unsuccessful bidders to respond, then can award the contract.
But from Reese’s statement, it’s apparently the regional vendor contract that the agency feels is problematic. The statement did not name the regions of the state that the insurer would cover within the SHBP.
“A timeline and additional details regarding this new process are forthcoming from the State Health Benefit Plan,’’ said Reese, who took over as Community Health commissioner July 1.
SHBP covers more than 650,000 state employees, teachers, school personnel, retirees and dependents. Currently, United and Cigna hold the contract, with United covering more than 90 percent of members.
Speculation on the winning bidder had centered on a single vendor — Blue Cross, the state’s largest health insurer.
United, though, filed a strongly worded protest to the pending award to Blue Cross.
“In what has to be one of the most egregious examples of a state entity acting outside the boundaries of Georgia procurement law, the Department of Community Health . . . is conducting a secret, hidden procurement for one or more 2014 health insurance plan,’’ said the United protest.
“DCH has been running two parallel procurements . . . , one secret and one public, for contracts to cover the same population, inviting only apparently-favored offerors to the secret procurement, and no one (other than DCH and a select few consultants) appears to have any understanding of the intended outcome for health care options to hundreds of thousands of Georgians,’’ the United protest continued.
The protest accuses the agency of “rogue’’ behavior.
Bert Kelly, a spokesman for Blue Cross, said in an e-mail to GHN on Thursday, “We submitted our proposals in accordance with all Georgia Department of Community Health, State Health Benefit Plan rules and regulations. As of this e-mail, we are aware of the notice of intent to award that was posted to the DCH site.”
The agency this week acknowledged that it set up a separate bid, and that some potential bidders, including Cigna and United, were not offered the chance to present a proposal, the AJC reported.
Asked why the department staged a second bid, a spokeswoman wrote in an email to the AJC that Community Health wanted “to solicit a response from a regional vendor to fulfill the state’s request for a potential contract for health coverage within certain geographical, cost and plan design requirements.”
Some industry officials told GHN recently that they fear Blue Cross’ reimbursements for services will be lower than the current rates, leading to a financial squeeze for some medical providers.
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