Amerigroup loses Ohio Medicaid contract challenge


Amerigroup has lost its challenge that claimed the Ohio Medicaid program improperly denied a contract for the insurer to manage care for about two-thirds of the state's Medicaid patients.

As one of six insurers that failed to win a state contract, Amerigroup filed a lawsuit against Ohio in August after an Aetna-initiated complaint was dismissed. The Virginia Beach, Va.-based insurer alleged that Ohio's evaluation and scoring process for determining bids to manage care for about 1.6 million Medicaid patients was faulty, reported the Columbus Dispatch.

But the Franklin County Court of Appeals ruled that Amerigroup didn't sufficiently prove that Ohio abused its discretion in awarding the Medicaid contracts. "Differences of interpretation, or even simple mistakes by [the Ohio Department of Job and Family Services] are not an abuse of discretion," the appellate court said, according to the Associated Press.

The decision means Amerigroup will lose its existing contract with the Ohio Medicaid program, which brought in $148 million in revenue in 2011, Columbus Business First reported.

In response to the court ruling, Amerigroup said it would continue exploring its legal options, including possibly appealing to the Ohio Supreme Court, the AP noted.

To learn more:
- read the Associated Press article
- see the Columbus Dispatch article
- check out the Columbus Business First article

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