House Wants Information On Managed Care Mergers

Feb 4, 2020

House leaders want health officials to assess the impact that mergers of managed-care companies have on choice and diversity of plans in Florida’s Medicaid system. 

The House included a provision in its proposed 2020-2021 budget that would require the Agency for Health Care Administration, which administers the Medicaid program, to assess the impact of any merger, sale, acquisition or consolidation that results in a plan having, or having control of, more than 30 percent of the Medicaid managed-care enrollment statewide or in any region.

The provision would direct the agency to consider the impacts on “consumer choice and provider network structure and diversity” and submit quarterly reports to legislative leaders and the governor beginning Oct. 1.

Centene Corp. last month announced it had completed its acquisition of Tampa-based WellCare Health Plans, linking two managed-care companies that had nearly 43 percent of Florida’s Medicaid market. Centene does business in Florida as Sunshine Health, while WellCare’s Florida Medicaid business has operated as Staywell Health Plan.

The companies provide coverage in similar markets in the state. A review of the latest enrollment data from the Agency for Health Care Administration showed that WellCare had a 25.8 percent market share, operating in 10 of 11 regions of the state. Centene has contracts in all 11 regions and had a 16.8 percent market share. The $17.3 billion merger was announced last March. Under a 2011 law, most Medicaid beneficiaries in Florida are required to enroll in managed-care plans.