Written by THE ASSOCIATED PRESS

The end of appeals by two insurance providers fighting how North Carolina’s health department decided who would run its new Medicaid managed-care initiative means legal challenges over the awarding of the contracts are now over.

The Court of Appeals last week agreed to accept the voluntary dismissal request by the two providers that lost out on contracts awarded in 2019 by the Department of Health and Human Services. Four conventional insurers and one physician partnership received the awards to run the program, which began last July and covers 1.6 million Medicaid consumers.

My Health by Health Providers — composed of 12 local hospital systems and a New Mexico-based insurer — contended the DHHS process was flawed and biased against provider-led organizations like My Health. Aetna Better Health Care of North Carolina also challenged the process, but a Superior Court judge limited its involvement in the case. The judge last year affirmed the decision of an administrative law judge upholding DHHS award decisions.

The two providers appealed and were scheduled to participate Wednesday in oral arguments before a three-judge panel. But the groups’ lawyers asked last week that their appeal be withdrawn.

“Although My Health still believes in the merits of its appeal and the promise of provider-led managed care, My Health and its North Carolina health system owners have decided that they do not want to disturb the management of care for over 1.6 million North Carolina Medicaid beneficiaries during this global pandemic,” the motion reads. Aetna also asked for a dismissal given My Health’s decision, the motion read.

The dismissal means there are no pending challenges involving the awarding of the managed-care contracts, a DHHS spokesperson said Tuesday.

DHHS Deputy Secretary Dave Richard, who oversees Medicaid, said this week in a news release that agency leaders are “pleased at this outcome and believe it affirms the integrity and fairness of the department’s procurement process.”

Under managed care, the state Medicaid program has moved most of its recipients from a traditional fee-for-service model to one in which organizations receive fixed monthly payments for every patient its providers see and treat.

 

Photo via Mark Stebnicki.

 

Related Stories
‹
As NC Waits for Medicaid Expansion, Federal Provision Could Leave Some in Coverage Gap
North Carolina lawmakers came to an agreement to expand the state’s Medicaid services. But a recent change may leave some in a healthcare gap.
Medicaid Expansion Bill Debate Is Renewed in North Carolina
Written by GARY D. ROBERTSON The North Carolina General Assembly began on Tuesday what could become the final push to expand Medicaid to hundreds of thousands of low-income adults in the state with a House measure that quickly advanced through committee with bipartisan support. The legislation scheduled for debate on the House floor Wednesday would direct […]
Here’s Where Jobs and Programs Are Being Cut at the Nation’s Top Health Agencies
Thousands of people were laid off Tuesday at the United States' top health agencies. Here are what positions and efforts were cut.
North Carolina’s New Governor Seeks More Helene Aid, Help for Families in Legislative Address
Written by GARY D. ROBERTSON RALEIGH, N.C. (AP) — New North Carolina Democratic Gov. Josh Stein gave his first address to a joint General Assembly session Wednesday night, hitting on familiar campaign and early-term themes of helping Hurricane Helene victims, making living expenses affordable and focusing on bipartisan accomplishments. Stein delivered the biennial State of the State […]
Extra Private School Voucher Funding Gets Initial Ok From North Carolina Senate
The North Carolina Senate took the first step in clearing the waitlist for private school vouchers after passing a supplemental spending plan.
All Qualifying North Carolina Hospitals Are Joining Debt-Reduction Effort, Governor Says
All qualifying North Carolina hospitals have agreed to participate in the first-of-its-kind initiative aiming to reduce medical debt.
US Regulators OK North Carolina Medicaid Carrot to Hospitals To Eliminate Patient Debt
Federal regulators signed off on a proposal to offer scores of North Carolina hospitals incentives to eliminate patients' medical debt.
NC Governor Visits Chapel Hill to Rollout Medicaid Coverage of Over-the-Counter Birth Control
Governor Roy Cooper joined North Carolina health officials in a Chapel Hill Walgreens pharmacy to make the announcement on Wednesday.
Cooper, Medicaid Leader Push Insurance Enrollment as North Carolina Medicaid Expansion Also Grows
Written by GARY D. ROBERTSON North Carolina is barely a month into the start of Medicaid expansion in the state and over 310,000 low-income adults have now enrolled in the government health care coverage, Gov. Roy Cooper said Wednesday while hosting the nation’s chief Medicaid regulator. The Democratic governor joined Chiquita Brooks-LaSure, administrator of the Centers for […]
North Carolina Medicaid Expansion Still Set for Dec. 1 Start as Federal Regulators Give Final OK
Written by THE ASSOCIATED PRESS Federal regulators have given their final approval for North Carolina to begin offering Medicaid to hundreds of thousands of low-income adults on Dec. 1, state health officials announced on Friday. The Centers for Medicare & Medicaid Services told the state in a letter Thursday that changes to North Carolina’s Medicaid program to provide […]
›