Molina loses Medicaid long-term services contract in Indiana
The state had already determined the company hadn't met readiness review requirements, regulatory filings show.
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Molina Healthcare will cease administering a long-term services Medicaid contract called Indiana Pathways for Aging, according to regulatory filings published this week.
The contract required the insurer to have a dual-eligible special needs (DNSP) plan ready for 2024, but Molina couldn't get the plan off the ground in time due to the administrative requirements of the Centers for Medicare and Medicaid Services, the filing said.
Indiana chose Molina, UnitedHealthcare, Anthem Blue Cross and Humana Healthy Horizons to administer the program back in March. Indiana's Pathways for Aging is designed to help seniors on Medicaid receive long-term, home-based care, and is intended to help members older than 60 remain in their homes.
The St. Louis Business Journal reported that the contracts are worth about $3.8 billion per company.
Molina said that it would have had a DSNP product off the ground by 2025, but the state had already determined that the company hadn't met readiness review requirements. The contract would have run for four years with the option for two renewal terms lasting one year apiece.
When it's launched, Pathways for Aging is expected to cover about 100,000 beneficiaries in the state.
The insurer said in the filings that Indiana is the sole state in its portfolio affected by the administrative requirements and that losing the contract would not materially affect the organization's financial outlook for 2024.
The Indiana Family and Social Service Administration is continuing its readiness review with the three other insurers slated to run the program.
THE LARGER TREND
This summer Molina said it would be purchasing the California Medicare Advantage business from Bright Health Group for an estimated $600 million in the purchase price for shares. The MA business includes the plans Brand New Day and Central Health Plan.
As part of the agreement, Bright Health Group's Consumer Care Delivery business will enter into a provider agreement with Molina to serve Medicaid and ACA Marketplace populations in Florida and Texas in 2024.
The closing is expected to occur by early 2024 and is not subject to a financing condition.
Twitter: @JELagasse
Email the writer: Jeff.Lagasse@himssmedia.com
