TALLAHASSEE — A battle is brewing over the right to offer HMO coverage to state of Florida employees.
Three insurance companies set to lose contracts under a new plan for providing coverage have filed a formal bid protest against the Department of Management Services, saying the agency inappropriately awarded AvMed the contracts for state workers, their dependents and retirees. A hearing is set for Monday.
United HealthCare, Florida Health Care and Coventry Health Care argue that the department miscalculated the costs of competing proposals and that AvMed isn't capable of delivering the services promised.
The new policy, part of the department's efforts to rein in health care costs, requires awarding HMO contracts to the lowest single bidder in each of the state's 67 counties instead of allowing employees to pick from two or three companies.
In late July, DMS chose AvMed to serve 38 counties, up from 30 under the previous plan. They include Hillsborough, Pinellas, Pasco, Miami-Dade and Broward counties. United HealthCare was awarded contracts for 18 counties, down from 67. Coventry's coverage area is dropping from 26 to four counties. And Florida Health Care is dropping from two counties to zero.
More than 177,000 employees and retirees are enrolled in state health care plans. Of those, nearly 85,000 are in HMOs. About 26,000 employees will have to switch companies under the changes, but the state is working to make sure they won't have to switch doctors, said DMS spokesman Kris Purcell.
"We think the impact is going to be fairly small in terms of the ability to see the same doctor they had," Purcell said.
The complainants say that instead of saving the state an estimated $400 million over two years, the policy will cost taxpayers nearly $500 million over two years.
"The department did not achieve a rational and meaningful price analysis," said Elizabeth Calzadilla-Fiallo, a spokeswoman for United. "It was impossible for the department to have determined whether the intended award constitutes best value."
Bid protest documents also say AvMed is rated "F" by the Better Business Bureau of South Florida and has experienced operating losses for several years.
"It is expected that additional information demonstrating AvMed's lack of fitness to be considered a 'responsible' vendor will surface," read the court documents.
A spokeswoman for AvMed said the bid protest is simply a case of sour grapes.
"The protests are coming from plans that did not have a favorable result," said Conchita Ruiz-Topinka, director of communications for AvMed Health Plans. "The state asked the competing HMOs to provide their best possible rates, and that's what we did."
Purcell said DMS is trying to reach a settlement with United, but the company seems only to want to be the sole provider for the state or to be offered in every county.
"If they were offered in every county it would cost an additional $50 million to $70 million per year," he said.
Open enrollment for state employee health care has been postponed from late September until early November.
Janet Zink can be reached at email@example.com or (850) 224-7263.