Magellan To Challenge Loss Of Medicaid Contract

Apr 27, 2018

Magellan Health intends to protest an Agency for Health Care Administration decision to shut the health plan out of the state’s Medicaid managed-care market.

In a filing Tuesday with the Securities and Exchange Commission, Chief Financial Officer Jonathan N. Rubin said the company was not invited by the state to negotiate a new Medicaid contract to provide services from 2019 to 2024.

Magellan currently offers a specialty plan for Medicaid beneficiaries with serious mental illnesses and had more than 79,000 enrollees as of April 1.

Rubin said in the filing that the existing Medicaid contract with Florida --- which expires at the end of the year --- generated net revenues of $605.9 million for the year that ended Dec. 31, 2017.

Magellan is the third health plan to publicly announce its intent to challenge the agency’s decisions.

Molina Healthcare, which provided services to more than 340,000 enrollees as of April 1, also announced in an SEC filing its intent to challenge the state’s decision to end its contract with the state.

Meanwhile, the AIDS Healthcare Foundation earlier this month filed a notice with the state requesting a hearing, but AHCA Secretary Justin Senior denied the request, saying it was premature because the state hadn’t finalized negotiations.

AHCA announced on Tuesday its plans to award five-year contracts worth upward of $90 billion with nine managed care plans, but Magellan wasn’t one of them.

Health plans have until Friday at 4:15 p.m. to file notices of protest with the state. See the Magellan SEC filing.