With No Medicaid Contracts, Molina May Leave New Mexico

Molina Healthcare claimed in legal documents that it may leave the state of New Mexico at the end of 2018 following the state’s decision to cut the company’s Medicaid contract.

“Medicaid is the most significant portion of Molina’s current business within the state,” the company wrote in a legal filing. The healthcare company argued that the state used a flawed process to decide which companies would receive the Medicaid contracts, and suggested one company may have had insider help to win a contract.

In January, the state announced that it would award contracts to begin January 2019 to Blue Cross Blue Shield of New Mexico, Presbyterian Health Plan and Western Sky Community Care, a subsidiary of Centene Corp.

Molina alleged that a consulting firm hired by the department to judge the evaluations had business ties to Centene Corp., which benefited Western Sky Community Care in the decision-making process.

“There simply is no legitimate reason that with price differences that amount to pennies on the dollar, Molina’s pricing score would be so significantly lower than other bidders’ scores,” said Daniel Sorrells, Molina’s New Mexico CEO, said in a statement about the decision.

Molina is seeking an injunction as well as a restraining order against Brent Earnest, secretary to New Mexico’s Human Services Department, in an effort to halt the state’s efforts to cancel the Medicaid contract, according to the Albuquerque Journal. It also filed a protest with the state against the decision.

However, department representatives have pushed back against Molina’s claims, arguing that the company’s argument was anecdotal and self-serving for the new incorporation provider. The department has requested the courts dismiss Molina’s claims outright.

The department also ended a contract with United Healthcare, which has not announced plans to leave the state.

Molina’s documents show that of 260,000 New Mexico insurance members, 224,000 are on Medicaid. Molina represents a quarter of the state’s Medicaid patients, according to the Albuquerque Journal.

The company employs 1,100 people in the state, according to KOAT Action News.

The healthcare company currently operates in 12 states as well as the territory of Puerto Rico. In September 2017, it announced that it would hire 250 more people in New Mexico to fill contact centers throughout the state, according to the Albuquerque Journal.