Then there were two: ImagineCare drops Medicaid managed care challenge

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ImagineCare has filed notice with the Agency for Health Care Administration (AHCA) of its intent to voluntarily drop its administrative challenge to the statewide Medicaid managed care procurement. 

ImagineCare was one of three rejected plans intending to challenge the latest round of Medicaid managed care contract awards in state administrative court. ImagineCare also filed a challenge in Leon County Circuit Court, though the plan is also expected to withdraw that challenge.

AmeriHealth Caritas and Sentara — the two other Medicaid managed care plans that notified the state of their intent to challenge the procurement — appear to be moving ahead with their challenges.

Florida requires most of its Medicaid enrollees, from the young to the old, to receive their health care through managed care plans. AHCA in 2023 released its Medicaid managed care ITN to renegotiate new multiyear contracts worth tens of billions of dollars to the winning bidders.

The state announced in April its intent to award new contracts with Florida Community Care; Humana Medical Plan; Simply Healthcare Plans; South Florida Community Care Network, which does business as Community Care Plan; and Sunshine State Health Plan.

Seven plans notified the state of their plans to challenge the decision. Some objected because they weren’t awarded contracts in the regions they were vying for, while others were protesting that they were left out completely.

After months of negotiations with some of the plans, AHCA announced in July additional contract awards, which settled four of the seven disputes, leaving three others outstanding.

ImagineCare is a type of health plan known as a provider service network (PSN). A joint venture of Spark Pediatrics and CareSource, ImagineCare does not currently have a Medicaid managed care contract in Florida. Sentara, also a PSN, also does not currently have any statewide Medicaid managed care contracts. AmeriHealth Caritas has Medicaid managed care contracts for two regions in the state.

Existing contracts are slated to expire at the end of the year.