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Aetna, 3 others appeal contract loss in state

PHILADELPHIA — Four losing bidders have protested the Pennsylvania Department of Human Services’ award last month of 3-year contracts to manage long-term care for Medicaid beneficiaries, the agency said Monday.

Pennsylvania’s Community HealthChoices represents a major overhaul of how the state pays for nursing home stays, home care, and other supports for the elderly and the physically disabled older than 21. The affected population totals about 420,000, including 120,000-130,000 seniors.

The statewide contracts, worth an estimated $5.4 billion in annual revenue, went to AmeriHealth Caritas, a majority-owned subsidiary of Independence Blue Cross; Pennsylvania Health and Wellness, a unit of publicly traded Centene Corp.; and UPMC for You, which is owned by the University of Pittsburgh Medical Center.

The companies that filed bid protests include units of three publicly traded companies: Aetna Better Health; Molina Healthcare of Pennsylvania; and WellCare of Pennsylvania. The fourth, Gateway Health Plan, is a joint venture of two tax-exempt organizations, Highmark Inc. and Mercy Health System of Southeastern Pennsylvania.

Contract negotiations with the winners have been stayed because of the protests.

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