NEW MEXICO (KRQE) – Nearly one million New Mexicans have a stake in the state’s Medicaid system. Soon, they’ll be served by a new health company after a battle over government contracts.
New Mexico’s government relies on countless contracts with private companies to carry out government-funded business, including healthcare. The process for deciding which contractors to work with begins with a “Request for Proposals,” where the government invites companies to submit cost estimates for government work. Generally, the company with the cheapest estimate, that can reasonably meet the requirements, gets the job. But when it comes to choosing Medicaid contractors, New Mexico’s Ethics Commission claims Governor Michelle Lujan Grisham didn’t follow the state’s rules.
In 2022, New Mexico’s Human Services Department (HSD) put out a Request for Proposals for Managed Care Organization Contractors for the state’s Medicaid program, called Turquoise Care. But after bids were sent in, the state pulled the request for contracts, allegedly under Lujan Grisham’s direction, and violating the state’s procurement code, according to the State Ethics Commission.
In a settlement with the State Ethics Commission, the governor claimed to have done nothing wrong, noting that all the applicants who submitted bids “raised significant concerns as to whether any of the bidders would be able to provide seamless, robust, and high-quality healthcare to New Mexicans.”
Now, the governor and the State Ethics Commission have agreed to put their differences aside – and set aside allegations of wrongdoing. Under the agreement, the state will reinstate the request for bids. HSD will now move forward with awarding contracts to four new contractors who put in bids. The state does not plan to renegotiate a contract with the current provider, Western Sky Community Care.
If negotiations go well, BlueCross BlueShield, Presbyterian Health Plan, United Health Plan, and Molina Health Plan will start serving the Medicaid managed care program beginning in July 2024. In the meantime, HSD says they are working on improving the existing contract so that New Mexicans can see immediate improvements in their care.
“The new contract go-live date will minimize disruption for Medicaid customers by allowing HSD to focus on the important work of recertifying eligibility for the 934,305 customers who are enrolled in the program,” HSD Acting Secretary Kari Armijo said in a press release. “We want all Medicaid customers to be watching for their turquoise envelopes and submitting the required paperwork to make sure they stay covered if eligible and to help them transition to other health insurance coverage if they no longer qualify for Medicaid.”
New Mexicans can renew their Medicaid coverage online at this link. They can also call 1-800-283-4465.
