Conflict of interest claims muddy billion-dollar North Carolina Medicaid contracts

The North Carolina Department of Health and Human Services asked a state tribunal reviewing how it awarded contracts for its managed Medicaid program to reject claims that its process was influenced by conflicts of interest, according to WRAL.

Advertisement

Aetna Better Health of North Carolina, which narrowly missed out on the contract, has alleged the department’s scoring process is flawed. The health plan claimed results may have been skewed by potential conflicts of interest between DHHS employees and Blue Cross. Blue Cross won one of five spots to help manage the program, which has an annual price tag of $6 billion.

The department and Blue Cross argue relationships, such as a romantic one between a committee member who analyzed proposals and a Blue Cross executive, don’t equal a full-on conflict of interest, according to WRAL. State officials were aware of the relationship, the department said. 

Aetna’s petition is before the state’s Office of Administrative Hearings, according to the report.

Read the full article here.

More articles on payers:
UnitedHealthcare issues layoffs in Minnesota
Verdict for ex-BCBS of North Carolina CEO: Guilty of DWI, child abuse charges
BCBS of Texas unveils first of 10 primary care clinics

At the Becker's 11th Annual IT + Revenue Cycle Conference: The Future of AI & Digital Health, taking place September 14–17 in Chicago, healthcare executives and digital leaders from across the country will come together to explore how AI, interoperability, cybersecurity, and revenue cycle innovation are transforming care delivery, strengthening financial performance, and driving the next era of digital health. Apply for complimentary registration now.

Register to Attend Webinar

Reconsider What’s Possible: Enterprise RCM and the Pro-Fee Practice

Tuesday, July 28
11:00 AM - 12:00 PM CDT

Presenters: Garett Kreitz, Med-MetrixJohn Stefanowicz, Med-Metrix

Advertisement

Next Up in Legal & Regulatory Issues

Advertisement

Comments are closed.