More deliberation with health exchange contracts needed, board member says

Health care contracts need more deliberation, exchange board says.

A member of the board that oversees the state exchange where people buy insurance plans under health reform said the entity needs to take more care in approving contracts.

"I think we can do this with a little more deliberation," said the board member, Dr. Georges Benjamin, who was also state health secretary under Gov. Parris N. Glendening.

During his comments at a meeting of the board Tuesday, Benjamin mentioned media reports criticizing the way some contracts were awarded. An article in The Baltimore Sun on Sunday said that on at least four occasions the board did not competitively bid the work for project management services. The contracts, obtained under a public information request, were worth up to $1.3 million.

Under state law, the exchange board operates under a separate procurement process from normal state contracting guidelines. While the board didn't do anything illegal in awarding the contracts, critics have said the procurement process raises questions about a lack of transparency.

The board said in documents that it awarded sole-source contracts, or those without competitive bidding, to companies that had "significant relevant experience" and a "unique appreciation" for the jobs, largely because they had already done some exchange or state work.

Emergency contracts were also awarded in some cases because of time pressures the board faced. When the first exchange was being built in 2013, the state often had to wait for federal guidelines to be approved. The slow approval process and constant rule changes sometimes left little time for bidding.

Significant technical problems with that exchange after it was launched eventually led to its being scrapped last spring and rebuilt. Once again, the board had to approve contracts quickly to get a new system by the next enrollment period, exchange officials have said.

"We built the system on the fly, no question. Now that it's flying and built, we can do it," said Benjamin, referring to being more thorough when awarding contracts.

"I totally agree," replied the current health secretary, Van T. Mitchell.

Shortly before Benjamin's comments, a discussion arose about why exchange staff wanted the board to award a $1.3 million emergency contract to the nonprofit HealthCare Access Maryland, to help Medicaid patients re-enroll through the new exchange.

Staff explained that the group was best qualified because it was already doing the work and knew both the old and the new systems. The exchange also faced a deadline for getting people re-enrolled.

The contract was awarded unanimously.

The board also received updated enrollment numbers during the meeting. A total of 122,778 people bought private health plans during open enrollment. Another 166,353 signed up for Medicaid.

amcdaniels@baltsun.com

Twitter.com/ankwalker

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