- Dennis Domrzalski
- Reporter- Albuquerque Business First
Lovelace Health Plan and two other insurers on Friday lost their appeals to be part of New Mexico’s $4 billion Medicaid program beginning Jan. 1.
New Mexico Human Services Department Secretary Sidonie Squier notified the insurers Friday morning that their appeals have been denied.
Also losing their appeals were Amerigroup Community Care of New Mexico, Inc., and Western Sky Community Care, both of Albuquerque. Neither company had existing Medicaid contracts with the state.
The one-page denial notices to the insurers from Squier said only that she agreed with in-house recommendations to deny the protests. The three firms have the right to appeal Squier’s decision to state district court, the letters said.
Lovelace Health System President and CEO Ron Stern said LHP’s loss of 74,000 Medicaid members would affect about 45 to 50 jobs at the health plan. Lovelace will look for ways to put those people in other jobs, Stern said. Lovelace will continue serving its Medicaid members through the end of the year, when its Medicaid contract with the state expires, he added.
“We are in the process of evaluating things and we think there will be 45 to 50 people at the health plan whose positions will be affected,” Stern said. “We will continue to serve our Medicaid patients and there is plenty of time to transition.”
In February, the Human Services Department awarded Medicaid contracts to four insurers: Blue Cross and Blue Shield of New Mexico, Presbyterian Health Plan, Molina Healthcare of New Mexico and UnitedHealthcare Community Plan of New Mexico.
Lovelace, Amerigroup and Western Sky had also bid on the Medicaid business but were not selected to be part of the program, which is called Centennial Care. In March, Lovelace and the two other firms appealed the decisions to the Human Services Department.
Lovelace’s Medicaid members accounted for $77.4 million in premiums during the first quarter, or 41 percent of the $185.5 million in premiums that Lovelace wrote in the quarter, according to its first quarter financial statement on file with the New Mexico Division of Insurance.
In the first quarter, Lovelace Health Plan had 144,190 total members, down from 151,676 in the first quarter of 2012, the financial filing said.
Stern said Lovelace Health System, which owns Lovelace Health Plan and six hospitals in New Mexico, “are strong organizations and will continue to grow and expand.
“We had a very successful Medicare enrollment last year and expect to have more success this year,” Stern said. He added that the health plan continues to add commercial members and that Lovelace Health System’s hospitals will continue to treat Medicaid patients in the future.
Stern said he hadn’t decided yet on whether to appeal Squier’s decision to state district court.