Blue Cross Blue Shield of North Carolina's legal challenge to win back the state health plan contract it lost to Aetna can continue, the News and Observer reported Jan. 24.
An administrative judge denied motions by the state health plan and Aetna to toss out the challenge, according to the outlet. The case is set to have a hearing in front of the state's Office of Administrative Hearings in February.
The state health plan, which provides coverage to more than 740,000 state employees, first announced its intent to award Aetna the contract in January 2023. BCBS North Carolina, which held the contract for over 40 years, filed its challenge in February. The contract includes healthcare spending of more than $17.5 billion over five years.
BCBS North Carolina argued that the process the state used to select the plan administrator was arbitrary.
"Serious errors were made in a procurement with significant ramifications for State Health Plan members," a BCBS North Carolina spokesperson said in a statement shared with Becker's.
An Aetna spokesperson told Becker's the company was awarded the contract because its bid was superior based on the scores set forth by the state health plan.
"We're incredibly excited to begin serving the State Health Plan next year, and we are already more than a year into our full-scale implementation effort," the spokesperson said.
In its initial challenge, BCBS North Carolina said it offered the lowest administrative costs, at $17.505 billion, compared to Aetna's $17.522 billion. The insurer also argued it had a larger provider network than Aetna.
In February, North Carolina state officials said Aetna won out because it scored higher than Blue Cross NC on technical components of the bid, and better than UnitedHealthcare, the third bidder for the contract, on costs.
"Additional details on the errors and distorted scoring in the process, as well as the failure to compare the bidders' networks of providers in any detail, will be presented at the February hearing," the BCBS North Carolina spokesperson said.
North Carolina State Treasurer Dale Folwell, who oversees the state health plan, told the News and Observer the challenge will proceed "to a transparent hearing where we can lay out our case and present our evidence in full view of the public."
"We are confident we will prevail on the merits," Mr. Folwell said.
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