Big state medical contract heading to court

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Big state medical contract heading to court

UnitedHealthcare goes back to court Wednesday in an effort to get a judge to stop the Department of Community Health’s move to make rival Blue Cross and Blue Shield the provider of health care to 650,000 teachers, state employees, retirees and family members.

UnitedHealthcare, which is currently one of the companies managing the state health benefits plan, has been battling DCH since before the agency announced plans to award the $3 billion a year business to Blue Cross and Blue Shield of Georgia starting Jan. 1.

UnitedHealthcare has filed a protest and legal action trying to block the contract, arguing that DCH held a secret bid that kept it from having a chance to earn the business. DCH officials acknowledged flaws in its handling of a small portion of the business - which allows Kaiser Permanente to offer HMOs to state employees in Atlanta - and announced last month that it would hold new bids for that coverage. However, the agency said it intended to award the larger contract to manage the program to Blue Cross.

In addition, the pharmacy business for the state health benefits plan was award to Express Scripts., Inc. A subsidiary of UnitedHeathcare was among the companies that bid unsuccessfully for that contract.

UnitedHealthcare lawyers argue that the entire process should be rebid and that DCH has hidden documents in an effort to keep the company from winning its case.

“State bureaucrats continue to engage in state-sponsored bid-rigging with Georgia employees’ health plans,” said Bill Jordan, a lawyer representing UnitedHealthcare and former chairman of the State Ethics Commission. “There is a pattern of unlawful conduct by the state of withholding essential documents. The state has already been caught promoting a secret procurement and now they keep changing the rules with regard to the provision of documents in a blatant attempt to game the system. With all this going on, how can taxpayers be confident that the government will properly administer state employees’ health care?”

Blue Cross and state lawyers said UnitedHealthcare is jumping the gun, trying to get a court to stop the award even before the Department of Community Health has ruled on its protest. Lawyers for the winning bids also said the lawsuit was frivolous.

Robert Highsmith, a prominent Republican attorney representing Express Scripts, released a statement saying, “We look forward to resolving this unnecessary and unwarranted litigation so that we can do the important work of helping people live better, healthier lives.”

This isn’t UnitedHealthcare’s only legal battle against Blue Cross in the South.

UnitedHealthcare filed another lawsuit in July asking a judge for an injunction to prevent the city of Birmingham, Ala. from carrying out a similar health care contract with Blue Cross.

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