Health Alliance says state used inaccurate data

URBANA — Health Alliance Medical Plans says it has learned a state agency used flawed information to select managed-care plans to provide health coverage for state employees and retirees.

Urbana-based Health Alliance has sent a letter to the Illinois Department of Healthcare and Family Services Director Julie Hamos requesting a meeting to set the record straight on "a number of factual errors and misapplied steps" used in the selection process.

"While HFS has gone to great lengths to defend the ethical procedures that must be followed, our greatest concern is not with the ethics of the procurement process or the parties involved. Our concern is that the decisions made are based on documentable facts and in the best interest of the state, its workers and the taxpayers who support the program," the letter states.

It also states the company doesn't believe the errors were made intentionally by the agency.

Health Alliance spokeswoman Jane Hayes said the errors came to light Friday when the company received a response from Healthcare and Family Services to its information request.

"What we're finding is the information that HFS was relying on wasn't accurate," she said.

Healthcare and Family Services spokeswoman Stacey Solano said in an emailed response to The News-Gazette that the agency remains confident about its choices.

"While the department can't get into specifics during the protest period, we are confident that the recommended awardees are vendors who can provide quality health care at the most reasonable cost for Illinois' employees, dependents and retirees. We look forward to the ruling of the Executive Ethics Commission so we can fully discuss the details of this decision," she said.

Hays declined to describe the errors the company found but did say they had to do with Health Alliance's costs and discounts and that assumptions were made based on information the agency didn't have.

"We don't want it causing embarrassment before we notified the director first," she said.

The state announced in early April that health coverage contracts for state employees and retirees would go to two Blue Cross and Blue Shield HMOs and two Open Access Plans operated by HealthLink and PersonalCare.

Protests were quickly filed by two rejected HMOs, Health Alliance and Humana.

Enrollment in managed-care plans that was to have begun May 1 with the opening of the benefits choice period for the fiscal year starting July 1 has been suspended until the disputes are settled and final contracts are awarded.

The protests are still in the hands of the state's Chief Procurement Officer Matt Brown.

Hays said Health Alliance can't direct its findings to Brown, because the allowable time to communicate with him in the protest process has passed.

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