If you are part of the MississippiCAN managed care program, get familiar with the name Molina.
Molina Healthcare of California was selected to be the third provider in the MississippiCAN managed care program by the Division of Medicaid and Centers for Medicaid and Medicare Services.
The procurement process invited insurance and healthcare providers from all over the country to bid for the third position. The other two positions, held by Magnolia Healthcare and United Healthcare could have been replaced in this process as well, but they were not.
One company, Mississippi True, was part of the process but was not selected. The company, which would have been the largest provider owned managed care program in the nation, was provided with a few reasons as to why they were not chosen.
“We were told it was because of experience and company structure,” said Timothy Moore, Executive Director of the Mississippi Hospital Association. “Which we see simply as a bias. We’re structured the way the legislature allows.”
Mississippi True providers are affiliated with over 60 hospitals in the state. Moore said the company has attracted national attention, and that Florida, Texas, Kentucky, Alabama, Georgia, and Alaska have contacted him about how they were able to get 60 hospitals to work together.
Moore said that contracts for the MississippiCAN program were signed immediately with Molina, despite the fact that the process was still in protest phase.
Officials with the Mississippi Department of Medicaid tell News Mississippi that this is proper procedure. The Centers for Medicare and Medicaid Services (CMS) requires the agency to get the contracts signed prior to submitting them to CMS. They want to ensure that both parties agree to the terms.
“Procurement staff follow a stringent procurement process in accordance with federal and state law and regulations to ensure a fair evaluation and scoring of proposals in response to procurements,” said Erin Barham, Deputy Administrator for Communications for Mississippi Medicaid. “Right now, the protest period is ongoing and protest arguments will be handled through that process. Meaning, we are following the administrative process and are actively working to respond to each protest.”
Barham added that the choice of providers is not limited to location, but whom they believe can provide the best services.
Leigh Woodward with Molina said the company will not comment on current procurement proceedings, but is happy to have been selected to be part of the managed care program.
“We are confident and looking forward to providing access to quality, cost-effective health care to Mississippians in the near future,” said Woodward. “This will be our first opportunity to work in Mississippi and we look forward to building relationships with provider and community partners across the state.”
Mississippi is the 12th state Molina Healthcare has been part of when it comes to managed care.
“Much of our success in the states where we already operate health plans is attributed to having a strong local presence and commitment to serving the community and our members at a grassroots level where we can have the most impact on their lives,” said Woodward.
Woodward adds that as the process moves forward, they do intend to build a local workforce in Mississippi, though the details are still being discussed.
“We look forward to working closely with local providers to deliver quality care to Mississippi’s Medicaid members,” said Woodward.