An administrative law judge has scheduled a September hearing to address challenges from two health plans that claim they were unfairly excluded from Florida’s new Medicaid managed-care contracts. The hearing will take place in Tallahassee from September 4th to 6th and September 9th to 13th.
AmeriHealth Caritas Florida and Sentara Care Alliance are contesting the decisions made by the state Agency for Health Care Administration, which denied them contracts to manage care for Medicaid beneficiaries. The agency announced its intent to award contracts to five health plans in April and added three more in July.
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These multi-year contracts represent tens of billions of dollars, with roughly 3.1 million Medicaid beneficiaries enrolled in managed-care plans. AmeriHealth Caritas and Sentara are challenging various elements of the year-long procurement process that led to the contract awards. Another health plan, ImagineCare LLC, recently withdrew its challenge.
Florida’s Medicaid managed-care system, established in 2011, requires most beneficiaries to enroll in managed-care plans.
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This latest contracting process, which began in 2023 and concluded this spring, is the third such process the agency has undertaken. Notably, the number of regions for which contracts are awarded has been reduced from 11 to nine in this latest round.
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