Additionally, the corporations claim that the government failed to provide documents that were required by the state’s openness rules.
They claim that the legitimacy and fairness of awarding a significant state contract are at risk.
In a letter challenging the decision in December, Peach State said that the State’s procurement was poorly managed, full of mistakes and careless actions.
Citing the ongoing procurement process, state representatives contacted by The Atlanta Journal-Constitution declined to comment on the accusations or state if the contract would be rebid.
When asked about the deal by AJC reporters, Carlson, who just quit his state post for an outside job, remained silent. He and DCH declared in a joint statement that his departure had nothing to do with the contract.
Medicaid, a state-federal health insurance program for low-income children and some low-income, elderly, and disabled adults, covers over 2.3 million individuals in Georgia. Under a few contracts, Georgia has been contracting with commercial health insurance companies to run the vital program since 2006.
Photo credit: Courtesy
Photo credit: Courtesy
Four businesses—CareSource, Humana Employers Health Plan of Georgia, Molina Health Care, and United Health Care of Georgia—were given contracts by DCH in December. However, while the protest is ongoing, those businesses have not taken up the task.
Whichever businesses win the contract in the end will be in charge of enrolling physicians and hospitals in the company’s Medicaid plan, processing patient care payments, and organizing patient care.
Since the outsourcing started in 2006, those contracts have been held by Amerigroup and Peach State Health Plan. About 460,000 Georgians are covered by Medicaid insurance managed by Amerigroup, while roughly 700,000 are covered by Peach State Health Plan. Both adult Medicaid participants and foster children are covered under the arrangement.
Under the current deal, 380,000 Georgians are covered by a third company, CareSource. That business is not participating in the protest and was chosen to stay with the state.
Carlson allegedly contacted a lobbyist for one of the other bidders, offering to give him a call to discuss the award’s timing, according to Peach State. According to the complaint, the procurement procedure was still in a blackout phase at the time, which meant that state representatives could not speak with any of the bidders about the deal other than through authorized middlemen.
The insurance companies also claim that the DCH violated the Georgia Open Records Act by not disclosing any text messages until a court filing compelled it to do so, and then producing so few that the business claims it was not a good faith attempt.
Georgia House of Representatives is credited.
Georgia House of Representatives is credited.
As part of their protest, Amerigroup has accused Department of Human Services Commissioner Candice Broce of scapegoating the company and damaging its brand. Medicaid eligibility is decided by DHS, which is distinct from DCH. In order to oversee the medical care of children in foster care or other state custody, Amerigroup had aimed to secure a separate Medicaid contract.
The firm cited a letter that Broce wrote to then-DCH Commissioner Caylee Noggle, stating that Amerigroup is frequently hard to get in touch with, even during regular business hours, and that providers claim they are not paid on time, which leads many to quit the network.
While the protest is ongoing, the state has delayed the contract start date until 2026.
