The Pennsylvania Department of Human Services (DHS) has confirmed that there will be no changes to the Physical HealthChoices managed care organization (MCO) assignments in early 2022. Results of two of the four MCO challenges to DHS’ decisions in response to the 2021 RFP process have been announced. The Commonwealth Court of Pennsylvania upheld on November 17, 2021, the state’s decision to deny protests filed by Aetna Better Health of Pennsylvania and Centene/Pennsylvania Health & Wellness after the two plans failed to win contracts in the state’s recent Medicaid managed care procurement. Rulings on protests from Gateway Health Plan and UnitedHealthCare have not been released publicly. Implementation of the new contracts, originally slated for January 1, 2022, have been suspended until the protests are resolved. In Behavioral HealthChoices, Magellan will change to CCBH in Delaware County effective July 1, 2022.
The list of MCO assignments are:
- BehavioralHealth MCO’s https://www.dhs.pa.gov/HealthChoices/HC-Services/Pages/BehavioralHealth-MCOs.aspx
- PhysicalHealthChoices MCO’s https://www.dhs.pa.gov/HealthChoices/HC-Services/Pages/PhysicalHealthChoices-MCOs.aspx
- CommunityHealthChoices MCO’s https://www.dhs.pa.gov/HealthChoices/HC-Services/Pages/CHC-MCOs.aspx