August 11, 2023

In ethics settlement, Lujan Grisham reverses Medicaid procurement cancellation

Jonathan Weiss/Medicaid

The State Ethics Commission announced Thursday that it reached a settlement between Gov. Michelle Lujan Grisham and the New Mexico Human Services Department over a terminated request for proposals for the Turquoise Care program.

The state issued the Turquoise Care RFP in September 2022 and then Lujan Grisham’s administration terminated the RFP in January 2023.

Five managed care organization contractors responded to the RFP and all but one, Western Sky Community Care, were awarded the RFP.

“State Ethics Commission alleges that on January 30, 2023, acting HSD Secretary Kari Armijo, following instructions communicated by Governor’s Office employees, sent the five offerors the Notice of Termination of Turquoise Care Medicaid Managed Care Request for Proposals,” the settlement agreement stated.

The SEC contends that the RFP’s termination violated the New Mexico Procurement Code.

Lujan Grisham denied all allegations of wrongdoing including the alleged Procurement Code violations.

The settlement agreement states Lujan Grisham’s reasons for terminating the RFP as the RFP applicants’ scores raised concerns if any of the five contractors “would be able to provide seamless, robust, and high-quality healthcare to New Mexicans,” the settlement agreement stated. “The decision was made to cancel the RFP and re-advertise the contracts with more stringent requirements and benchmarks for service providers in reliance on HSD’s assessment that the Procurement Code did not apply to the RFP process.”

HSD also denies wrongdoing.

The settlement came following mediation with retired New Mexico Supreme Court Justice Judith Nakamura serving as mediator.

The settlement agreement includes HSD rescinding the RFP termination and notifying the five applicants who responded to that RFP; HSD notifying its intent to award the four winning applicants for the MCO contracts: Health Care Service Corporation d/b/a Blue Cross and Blue Shield of New Mexico, UnitedHealthcare of New Mexico, Molina Healthcare of New Mexico, Inc., and Presbyterian Health Plan; that Presbyterian Health Plan was awarded the contract for them to provide managed care children in state custody; HSD has to notify Western Sky Community Care that it was not selected for an MCO contract following HSD’s evaluation; and HSD shall begin its negotiations with the four winning contractors.