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LINCOLN — Nebraska officials announced Friday that they have chosen three health plans to manage the bulk of the state’s $1.8 billion Medicaid program.
The three are Molina Healthcare of Nebraska, Nebraska Total Care and UnitedHealth Care of the Midlands. Two, Nebraska Total Care and UnitedHealth Care, have current contracts with the state. Molina HealthCare is new to Nebraska but provides Medicaid, Medicare and Affordable Care Act marketplace plans in several other states.
“We’re excited to work with these three health plans to ensure Medicaid members in Nebraska continue to receive the health care that they need,” said Dannette R. Smith, CEO of the Nebraska Department of Health and Human Services.
HHS plans to contract with the three companies to manage physical and behavioral health care, pharmacy services and dental benefits for almost all Medicaid patients in a program called Heritage Health. Together, they will oversee the care of some 347,000 Nebraskans.
The winning bidders were selected from among five contenders. Not chosen were Community Care Plan of Nebraska, doing business as Healthy Blue, which currently contracts with the state, and Medica Community Health Plan, which currently offers health coverage to Nebraskans through the ACA marketplace.
It remains to be seen whether either of the losing bidders will appeal the state's decision, as occurred when the current contracts were awarded.
State lawmakers have criticized Nebraska's procurement process after at least three cases in which the process led to the selection of a low-cost bidder that ended up failing to do the job.
State Medicaid Director Kevin Bagley said he was "extremely pleased" with all five bids. He said they were scored based on quality, appropriateness and thoroughness, and officials did an optional interview with each bidder to find out more about their plans and priorities.
Bagley said key issues during the interviews included incorporating dental services within the health plans, actively using voluntary care and case management to improve members’ lives, standardizing certain requirements for providers, providing innovations to add value to members’ health care experiences and improving access to providers across Nebraska.
The new contracts are slated to start Jan. 1, 2024, six months later than previously planned. Bagley said officials will be working with the three plans during that time to provide for an orderly transition from the current contracts.
In addition, he said, Medicaid officials will be meeting with people across Nebraska, both in person and online, to talk about the changes, answer questions and adjust plans as needed. A listening tour will be held in mid- to late October, with more details to come.
The current Heritage Health contracts date to 2017, when the state signed with three private companies to administer what was then $1.2 billion worth of Medicaid services. Since then, two of the original three companies merged, which led to the state signing a contract with Healthy Blue.
Heritage Health does not cover nursing home care and other long-term support and services for the elderly and people with disabilities.
martha.stoddard@owh.com, 402-670-2402, twitter.com/stoddardOWH
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Martha Stoddard keeps legislators honest from The World-Herald's Lincoln bureau, where she covers news from the State Capitol. Follow her on Twitter @StoddardOWH. Phone: 402-670-2402
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