PHOENIX – On September 8th, The Arizona Health Care Cost Containment System (AHCCCS) issued a Director’s Decision (Decision) which denies the appeal of Mercy Care, BCBS of Arizona HealthChoice, and Banner-University Family Care regarding the EPD Procurement process and awards. The Decision found that AHCCCS properly exercised its discretion in the procurement process in accordance with law and that the non-awarded health plans failed to timely protest alleged procurement deficiencies as required by state administrative rules. Further, the Decision found that even if the non-awarded health plans timely filed protests, they failed to show that the alleged errors created a disadvantage to them, that the procurement process operated in a manner contrary to the law, or that they had a substantial chance at receiving an award. AHCCCS applied the procurement process fairly to all bidders, including the non-awarded health plans.
Based on the Director’s Decision to deny the appeal, the agency plans to move forward with the award of the EPD contracts to Health Net Access, Inc. (dba Arizona Complete Health-Long Term Care Plan) and Arizona Physicians IPA, Inc. (dba UnitedHealthcare Community Plan). By law, the non-awarded health plans will have the opportunity to either file a Motion for Rehearing or Review with the agency or file an appeal in Superior Court to seek judicial review.
At this time, no determination has been made on when planned transition activities will resume. AHCCCS will be evaluating operations and processes and will be utilizing feedback the agency received from members and interested stakeholders to inform the transition process. AHCCCS will keep members, providers, and stakeholders informed of updates regarding the transition process. Members and providers will be receiving notice of the transition processes well before they begin. The smooth transition of members remains the top priority of the agency. At this time, members will remain with their currently enrolled health plan.
For any questions regarding this decision, please view the AHCCCS EPD Decision Fact Sheet, or reach out to MCOTransitions@azahcccs.gov.
