Pennsylvania has put billions in Medicaid business out for bid
The Medicaid managed-care contracts cover nursing homes, home care, and other long-term services for more than 400,000 low-income Pennsylvanians.
The Pennsylvania Department of Human Services put more than $5 billion in annual Medicaid business out for bid this week.
The managed-care contracts cover more than 400,000 state residents enrolled in a program known as Community HealthChoices, which pays for nursing homes, home care, and other long-term services for low-income seniors and disabled people who qualify for both Medicare and Medicaid.
Separate Medicaid managed-care programs cover physical health and behavioral health and are not part of the request for bids.
The human services department said in the bid document that Community HealthChoices “aims to serve people in the community, giving them the opportunity to work, spend more time with their families, and experience an overall better quality of life.”
Independence Blue Cross’ AmeriHealth Caritas, UPMC, and Centene Corp. are the current holders of the long-term services contracts, which started in 2018 in Southwestern Pennsylvania. Applications for the new contracts are due March 15.
This is the second time the business has been up for bid. The prior contract round started in 2015, but was delayed through protests by losing bidders, including UnitedHealthcare of Pennsylvania. It’s not usual for losing bidders to force a lengthy delay, given the profits at stake.
The state budgeted $5.38 billion for Community HealthChoices in the year that ends June 30.