Molina ‘likely’ to leave New Mexico after losing Medicaid contract: 4 things to know

Molina Healthcare of New Mexico said it will ”likely” exit New Mexico if the insurer isn’t awarded a contract to manage the state’s Medicaid program, according to court documents obtained by the Albuquerque Journal.

Advertisement

Here are four things to know about Molina’s lost bid.

1. New Mexico chose Blue Cross Blue Shield of New Mexico, Presbyterian Health Plan and Western Sky Community Care to manage Medicaid beneficiaries. UnitedHealthcare and Molina, both in the last year of their five-year contracts to manage the program, lost bids to retain their roles beginning in 2019.

2. In recent court documents, Molina said if it’s ”not awarded a contract, which is [Human Services Department]’s current path, Molina will likely leave New Mexico entirely since Medicaid is the most significant portion of Molina’s current business within the state.”

3. Molina has 1,100-plus employees in New Mexico and insures about 260,000 customers, with 224,000 being Medicaid recipients, according to the Albuquerque Journal.

4. On Monday, Molina filed a lawsuit against the New Mexico Human Services Department over its lost bid. The insurer is also seeking an injunction and restraining order against the department.

More articles on payer issues:
Top 6 BCBS plans see Q3 profit margins improve
DOJ requests information on $69B CVS Health-Aetna deal: 3 things to know
25k removed from Indiana Medicaid for not paying premiums: 5 things to know

Becker’s 3rd Annual Fall Chief Pharmacy Officer Summit is the top tier event that the people leading the future of pharmacy convene. This 3-day event is built specifically for Chief Pharmacy Officers and senior pharmacy leaders. The sessions examine the workforce, financial and clinical priorities shaping pharmacy today. Becker’s is where candid discussions flourish and new ideas thrive. Becker's 3rd Annual Fall Chief Pharmacy Officer Summit

Advertisement

Next Up in Transactions & Valuation Issues

Advertisement

Comments are closed.