Bookmark & ShareOn September 11, 2009 an administrative law judge (ALJ) ruled there were procedural errors in the UMP TPA procurement process and instructed the Health Care Authority to correct the errors and start the process over. As a result of this decision, HCA also had to terminate the May 8, 2009 contract awarded to Aetna as the UMP TPA for the period January 1, 2010 - December 31, 2013.
We will utilize an interim vendor to perform UMP's administrative services for the 2010 benefit year covering January 1, 2010 through December 31, 2010. The one-year interim contract will be negotiated with a vendor with the capacity to effectively maintaining UMP's high level of service for members. As soon as the contract negotiations are completed we will announce the name of the interim vendor.
Because this interim contract will be for one year, we do not expect any significant changes to UMP for 2010. UMP will look much the same in 2010 as it has in 2009. The Washington provider network will continue to be under contract directly with HCA for 2010 and will use HCA's negotiated fee schedule. Network providers who previously received notice their contracts would be terminated at the end of 2009 will be receiving updated information directly from HCA in the next few weeks.
We are still evaluating how best to secure a new long term vendor contract for UMP’s administrative services in light of the ALJ's ruling and will provide information as decisions are made.
