Aetna, AmeriHealth Caritas, Centene Corp., Meridian Health Plan, UnitedHealthcare and WellCare Health Plans have submitted bids to manage Nebraska's $1.8 billion Medicaid program.
Nebraska's Medicaid department will evaluate the proposals and pick three winners by Jan. 29. The contracts, which will be finalized March 1 and start Jan. 1, 2017, will cover medical care, behavioral health and pharmacy services.
Aetna, AmeriHealth and UnitedHealthcare are Nebraska's incumbent Medicaid insurers. Magellan Health separately operates the state's behavioral health and substance abuse services.
The winning parties will receive monthly lump-sum payments for each low-income member they cover, and at least 85% of the capitated revenue must go toward medical care, according to Nebraska's Medicaid documents. Approximately 230,000 adults and children will be covered under the managed Medicaid program. Nebraska is one of 20 states that have not expanded Medicaid under the Affordable Care Act.
Nebraska has not been alone in re-evaluating its privatized Medicaid program. Georgia awarded new contracts last September, and the same insurers who previously ran Georgia's program won the rebid.
Iowa's shift to managed Medicaid has been controversial. The state decided to move away from the fee-for-service Medicaid structure to the privatized managed-care version. Iowa awarded contracts to four insurance companies, but late last year, it rescinded its offer to WellCare because of a lack of disclosure during the bidding process. The new program also was supposed to start Jan. 1, but the CMS forced Iowa to delay the start until March 1.
