Appeal Filed to Block Prestige Health

Mar 4, 2014

A South Florida health plan ramped up its legal challenge to the state’s decision to award a Medicaid managed-care contract to a competitor, the News Service of Florida reports.

Care Access PSN (for "provider service network") wants the 4th District Court of Appeal to block the state's contract with Prestige Health Choice for patients in Miami-Dade and Monroe counties.

The Agency for Health Care Administration rejected an administrative judge’s ruling and issued the contract to Prestige, a provider service network with ties to Florida Blue.

As Health News Florida reported in January, the administrative judge said Prestige didn’t meet the definition of a PSN. Not all of its providers were not true non-profit health centers, Judge John Van Laningham said.

AHCA disagreed and signed contracts to allow the Medicaid managed-care program to roll out this summer, as planned. Care Access said AHCA is violating the law.