Centene's FL Medicaid contract taken up by Molina.
14 replies (most recent on top)
@hx Several accurate points here. Providers increasingly prefer to avoid government insurance, especially Medicaid. Reimbursement rates are undesirable for many providers and they simply choose not to participate. And the ACA is on its last legs. It may have a few years left, but it just hasn’t worked out the way it was intended, especially without the subsidies propping it up.
The population was bankrupting sshp. It’s honestly a good thing.
@es Try to pay attention - it does not matter if it's a new contract or old. They were bidding on it because.....yup, that's right $$$$$$$$$$$$$$$$$$. No one knows for certain because this company is NEVER honest or transparent. Given its track record, I would wager they wouldn't make enough to appease their GODS. And again, they are losing Medicaid left and right, so no matter how you try to spin it, they will lose revenue in the long run and have to offset those costs ....and AGAIN by doing what they are now well known to do......FIRE PEOPLE. I won't even start with how providers no longer want to deal with Medicare, and Marketplace is nothing but a dumpster fire.
@es it is in fact a contract Sunshine is currently administering which ends 9/30/26. The business was up for renewal hence the ITN and recent announcement to Molina
Centene exited the contract because it was unprofitable. That’s how Molina got it.
We weren’t making money off of these kids anyway.
@e3 louder for the people in the back: this is NOT an existing or “retained” contract, it’s new. not great that Centene didn’t get it but get your facts straight.
Found an article that says -
"The administration of Gov. Ron DeSantis has announced its intent to award a multibillion-dollar Medicaid managed-care contract for medically complex children to Molina Healthcare of Florida.
The decision, announced earlier this month, is not final and can be challenged. Vendors had 72 hours following the Nov. 3 announcement to notify the state of their intent to challenge the decision.
Thereafter, statutes provide vendors an additional 10 days to file formal written protests with the state.
The Agency for Health Care Administration did not immediately say whether it had received any protest notices.
But Sunshine Health, the wholly owned subsidiary of Centene Health, won’t be challenging “at this time” and attributed the decision to “concerns related to terms contained in the final version of the state’s [invitation to negotiate] that we were not able to agree to.”
The company did not elaborate on what those concerns were.
“Having served this program statewide, we have a deep understanding of the level of service and care the children who rely on this program need,” the statement read. “In evaluating the state’s proposed terms, our understanding of this population informed our consideration of multiple key factors, including whether the terms align with our mission of transforming the communities we serve, are sustainable for us as an organization, and will ultimately enable Sunshine to provide our members the quality care they deserve.”
Makes me wonder if they fear the cost to serve these children are going to be higher than money the contract gives.
@e1 What is confusing? Complex or not, the bulk of Medicaid recipients are children. Any contract loss cuts revenue - resulting in ONE thing and ONE thing only - layoffs. FL is just the beginning; many providers are not renewing contracts because of Centene's fraud, and lawsuits are catching up with them.
Reading conflicting information regarding this. Was it just the special pediatric population contact or the whole thing? Very big difference.
Sounds like we have some on here defending one of the most corrupt corporations , saddle up it’s looking like Centene is going down & that is very unfortunate they have employees thinking this lay off is all a “‘RUMOR “ news flash it’s not so all you on here trying to justify something that is already being justified by propers avenues and again you lost CMS. One of the most important LOB Centene has targeted the most vulnerable community our LTC folks and our CMS kiddos SHAME on you !
@dd Whatever...lol..."gloom and doom" where do you see that? No one is preaching anything but the facts. Your projection on OPs post means nothing more than you already know that there will be layoffs due to this. ANY reduction in retained contracts mean less revenue and more layoffs. Just stop.
@OP this is a new Medicaid contract for medically complex children, NOT the entire LOB, and it’s not even finalized yet. get your facts straight before you preach doom and gloom.
This is what happens when a corporation gets too greedy and does not pay instead they pocket the money shame on centene sunshine health and congratulations to Molina I’m sure they will manage that LOB better.