Florida UnitedHealthcare Signs HMO Contract

Sep 24, 2011

The following article was posted to the WCTV website on September 24, 2011:

Florida UnitedHealthcare Signs HMO Contract

By Jim Saunders

Florida is moving forward with a plan that will lead to health-insurance changes for thousands of state employees, after an appeals court broke a legal logjam this week.

The state Department of Management Services said Friday that UnitedHealthcare of Florida signed a contract to provide HMO services in 18 counties.

That announcement came after the 1st District Court of Appeal rejected parts of a legal challenge filed by United and declined to issue a stay. The other 49 counties will be divided among five HMO’s that reached agreements with the state last week.

The department contends that the changes will save an estimated $400 million over two years, in part because of competition for the contracts. In most cases, employees will only be served by one HMO in each county, though they also can choose a preferred provider organization (PPO) plan offered by Blue Cross and Blue Shield of Florida.

“The procurement process and awards made by DMS were sound and appropriate and achieve significant value for the state,” Department of Management Services Secretary John P. “Jack” Miles said in a prepared statement.

The changes will take effect Jan. 1, and an open enrollment period for employees will be held Nov. 7 through Nov. 18.

The initial version of the plan would have allowed only one HMO in each county. United, Coventry Health Care of Florida and Florida Health Care Plans — which all stood to lose business in counties they now serve — filed cases in the state Division of Administrative Hearings.

United argued that the process of awarding the contracts was flawed and didn’t take into consideration discounts it could get from providers. But an administrative law judge tossed out United’s challenge, which prompted the company to go to the 1st District Court of Appeal.

Meanwhile, Coventry and Florida Health Care Plans reached settlements with the department. Also signing contracts with the department were AvMed, Capital Health Plan and Aetna.

The appeals court rejected most parts of United’s challenge Wednesday, prompting it to accept a contract to serve the 18 counties that the department awarded to it. That means United will lose state-employee business throughout the rest of the state, including in the largest metro areas.

Along with signing the contract, it was not immediately clear Friday afternoon whether United also would drop the remaining part of the appeal. A docket on the 1st District Court of Appeal’s website did not indicate that the case had been dropped.

Under the agreements, six counties — Miami-Dade, Broward, Palm Beach, St. Lucie, Volusia and Flagler — will be served by two HMOs. All other counties will have one HMO.

AvMed will serve 37 counties, including those that have two HMOs. Capital Health Plan will be the only HMO in Leon County and six nearby counties that are loaded with state employees and retirees.

Find this article here:  http://www.wctv.tv/news/headlines/Florida_UnitedHealthcare_Signs_HMO_Contract_130504888.html