Molina Healthcare secures Medicaid Managed Care contract for Miami-Dade and Monroe counties

by | Jul 19, 2024



Molina Healthcare was awarded a new Medicaid managed care contract by the Florida Agency for Healthcare Administration to serve approximately 90,000 beneficiaries in Miami-Dade and Monroe counties.


Molina Healthcare was awarded a new Medicaid Managed Care contract by the Florida Agency for Healthcare Administration (AHCA).

The contract, announced Friday, grants Molina Healthcare of Florida, Inc., a subsidiary of Molina, the right to serve approximately 90,000 Medicaid beneficiaries in Miami-Dade and Monroe counties. The contract term will commence on January 1, 2025, and extend through December 31, 2030.

This award represents an expansion for Molina Healthcare within Florida’s Medicaid program, as the company prepares to provide managed care services to a substantial portion of the state’s Medicaid population in the designated counties.

The announcement comes after concerns were raised surrounding AHCA’s recent Medicaid contract procurement process. Several healthcare providers filed protests after not being selected for new contract, alleging irregularities and biases in the selection process. Molina was among the companies raising concerns, describing the procurement process as “fundamentally flawed” in their official protest.

Molina’s objections, shared by other major healthcare providers such as United Healthcare and Sentara Care Alliance, focused on alleged inconsistencies and biases in the evaluation criteria, as well as non-disclosures and arbitrary measures.

Molina’s protest claimed that AHCA’s actions were “contrary to the governing statute of the ITN, such that its decision was clearly erroneous, arbitrary, and capricious, and contrary to competition.”

AHCA announced in April its intention to award contracts to five healthcare organizations for the Statewide Medicaid Managed Care Program.

The selected firms included Florida Community Care, to cover Regions A, B, C, D, and I; Humana Medical Plan, and Simply Healthcare Plans, both assigned statewide responsibilities; Community Care Plan, covering Regions E, F, G, H, and I; and Sunshine State Health Plan, serving a statewide demographic and catering to all three specialized care categories.

The re-procurement process, which involves contracts worth billions of dollars, determines which healthcare providers will manage Medicaid services for the state.

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