The complexities of Medicaid often contribute to the confusion of the program. Here, we break down some of the numbers for Mississippi Medicaid.
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Two years before winning a billion-dollar Medicaid contract, Molina Healthcare offered the agency’s director a job. At least that’s what attorneys said they could prove in court Monday before never getting the chance.
The Mississippi Division of Medicaid awarded Molina Healthcare of Mississippi a contract to run MississippiCAN, the state’s managed care program, in June alongside incumbent companies UnitedHealthcare and Magnolia Health.
The attorney for Mississippi True — a nonprofit, hospital-backed Provider Sponsored Health Plan that came in seventh out of seven during the evaluation of proposals — said he has emails from January 2015 and August 2016 that show Molina offered Medicaid Director David Dzielak a job.
But it only looks that way, according to the agency and the company in question.
“That statement is false,” said Carl Gardner, a Molina legal representative.
“We did not offer Dr. Dzielak a job or anyone else at the division.”
As far as the emails, which the judge sealed, “(The attorney) is reading them out of context,” Gardner said.
“The emails were not delivered in the context of the Mississippi True bid,” Gardner said. “They were not delivered to offer Dr. Dzielak a job. One of the emails was in reference to the bid but it was not offering Dr. Dzielak a job.”
Gardner would not explain further the intent of the email exchanges.
“Dr. Dzielak was never offered a job by Molina and never expressed any interest in working for Molina. The emails referenced in court were completely misconstrued. Moreover, the emails cited were exchanged long before the procurement process began and before Molina bid on the contract,” said a statement from Medicaid.
Medicaid did not respond Monday to The Clarion-Ledger’s public records request for the specific emails.
Mississippi True claims Dzielak broke the law by failing to recuse himself from the evaluation process and failing to notify the Mississippi Ethics Commission about his conflict regarding Molina.
Medicaid’s statement emphasized Dzielak’s lack of involvement in the evaluation, saying he only approves the selection of the evaluators and then accepts their recommendation.
More: Lawsuit: Medicaid signed billion dollar contract despite protests
Mississippi True and another losing bidder, Amerigroup, filed suit over the award and asked Monday for a temporary restraining order and for Medicaid to redo the procurement. The judge did not grant their request.
The $2 billion contract, one of the largest in the state’s history, has caused a stir among Mississippi’s health care professionals, including some state lawmakers.
MississippiCAN’s goal is to save the state Medicaid dollars in part by keeping folks healthier and therefore less likely to need expensive services. The companies that manage the program are responsible for paying Medicaid claims for a large portion of the state’s Medicaid population.
At 10 a.m. Monday, over a dozen attorneys filed into Hinds Country Chancery Judge William Singletary’s courtroom.
“Way too many attorneys for one case,” murmured an attorney representing United.
Another pointed to the lawyers sitting at the back of the room, repeating, “$500 an hour, $500 an hour.”
“Y’all are making some damn money around here,” he said as he walked out of the courtroom.
All five companies — the three that won and two that lost the contract — have intervened in one way or another on the lawsuit.
As much as the companies are spending on attorneys to fight or defend the procurement, even more is on the line for the taxpayers, who will funnel billions to the companies to pay Medicaid claims.
Instead of granting Mississippi True and Amerigroup’s request for relief, Singletary gave Medicaid seven days to review evidence presented in court Monday, including the emails between Dzielak and Molina.
Mississippi True attorney George Ritter retrieved the emails on Aug. 8 through a public records request he filed June 26. The records cost $30,000.
Medicaid attorney Kathryn Gilchrist said the emails are public and do not contain any protected information, but because Ritter presented them in a large packet to the court on short notice, the judge sealed them.
More: Hospitals: Mississippi favored for-profit, out-of-state company to manage Medicaid
Both of the losing companies previously filed official protests with Medicaid on June 29, but the division signed the contracts with Molina, United and Magnolia the next day.
The contracts did not go before the Public Service Contract Review Board for further evaluation, another complaint of Mississippi True and Amerigroup.
Attorneys for Medicaid argued Monday the courtroom is not the appropriate environment for the losing companies to present complaints because the department’s own administrative procedure for evaluating protests has not concluded.
“They could still win,” said Everette White, an attorney for Medicaid.
Ritter argued his client had no obligation to exhaust its administrative options for relief because Dzielak broke conflict of interest laws by failing to recuse himself from the evaluation and report the conflict regarding Molina to the Mississippi Ethics Commission.
By the time the parties meet in court again after Medicaid has time to review the documents, the deadline for losing companies to file amended protests will have passed.
“It will have been too late,” argued Amerigroup’s attorney Mark Halbert.
Halbert argued Dzielak, who has a conflict, will have a say in the result of the protests at a disadvantage to his client.
The agency has until Aug. 22 to file its responses to the protests.
Singletary agreed in part with Medicaid, suggesting his court did not have jurisdiction over the matter.
“I’m gonna let that (administrative process) run its course before I wade into that any further,” Singletary said.
Medicaid’s full statement regarding this story:
“The Mississippi Division of Medicaid (DOM) is pleased with Judge Singletary’s decision on Monday to let the administrative process run its course with regard to protests challenging the procurement and awards for the MississippiCAN contracts.
DOM procurement staff follow a rigorous procurement process in accordance with federal and state law and regulations to ensure a fair evaluation and scoring of proposals in response to procurements. As is common with such procurements, bidding companies who are not awarded a contract often challenge via protests and legal action. DOM will give careful and full consideration to all arguments set forth by the protesters in this matter in support of their respective positions.
Statements made in court today by Mississippi True’s attorneys regarding an offer of employment to Dr. David Dzielak, executive director, by a Molina Healthcare representative are false. Dr. Dzielak was never offered a job by Molina and never expressed any interest in working for Molina. The emails referenced in court were completely misconstrued. Moreover, the emails cited were exchanged long before the procurement process began and before Molina bid on the contract.
Regardless of these claims, Dr. Dzielak is in no way involved in the procurement evaluation process. While he approves the selection of the evaluation committee members, he does not attend evaluation meetings, is shielded from the bidding companies’ oral presentations, and has no input in how the proposals are scored. Dr. Dzielak is unaware of the official results on the procurement until he is handed the procurement officer’s recommendation. In this particular procurement, Dr. Dzielak accepted and affirmed the procurement officer’s recommendation without modification.
DOM looks forward to continuing with the administrative process and intends to file its formal responses – or final agency decisions – by Aug. 22.”
Contact Anna Wolfe at 601-961-7326 or awolfe@gannett.com. Follow her on Twitter.