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Medicaid’s managed care contracts at a standstill after two companies cry foul

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More than a year after Mississippi Medicaid announced it was contracting with three companies to manage the care of their beneficiaries, those contracts have not been awarded.

That’s because two companies that weren’t chosen say the selection process was unfair.

UnitedHealthcare and Amerigroup, two for-profit managed care companies, were not chosen by Mississippi Medicaid as one of its contracted companies entrusted with managing beneficiaries’ health care. The two organizations have subsequently filed protests with the state, alleging the selection process was flawed, leading to a months-long stalemate over who will manage Mississippi Medicaid beneficiaries’ care after next summer.

The stakes are high: the contracts, funded by state and federal dollars, are worth billions.

The majority of Medicaid recipients in most states are enrolled in managed care organizations. Through a lucrative contract agreement, divisions pay these companies to deliver services to beneficiaries.

In exchange for a monthly payments — regardless of whether services were or were not used by a beneficiary during that period — the managed care organization must maintain a network of providers for its enrollees and ensure enrollees are not billed for covered services.

Managed care for Mississippi Medicaid beneficiaries began in 2011 with the inception of the division’s “coordinated care program,” or its managed care system called MississippiCAN.

According to its website, MississippiCAN currently provides health insurance benefits for more than 480,000 of the state’s most vulnerable citizens, including poor adults and children, people who are disabled and pregnant people. Medicaid insures about 837,000 Mississippians total as of September.

The Mississippi Division of Medicaid is located in the Walter Sillers Building, seen here on Monday, Oct. 16, 2023, in Jackson, Miss. Credit: Eric J. Shelton/Mississippi Today

Though they’re theoretically well-intentioned — to increase services for beneficiaries and reduce costs for Medicaid — managed care organizations have been criticized by politicians, patients and health care leaders for prioritizing profit and hindering patient care.

Managed care organizations’ performances can vary greatly, and which ones the Medicaid agencies contract with is up to them. That’s decided through a process called procurement.

In December 2021, the Division of Medicaid began seeking new contracts and solicited “requests for qualifications” from managed care companies. Five prospective contractors submitted proposals in March 2022.

Mississippi Medicaid announced in August 2022 that it intended to award contracts to three of those: TrueCare, Magnolia Health and Molina Healthcare.

TrueCare, a not-for-profit company, was created by hospitals along with the state hospital association to provide what they believe is better care to patients, compared to traditional managed care organizations.

Molina Healthcare and Magnolia Health are both privately-owned companies that already administer services to Medicaid beneficiaries, along with UnitedHealthcare.

Magnolia has gotten the biggest contracts of all three — almost $9.3 billion for its contracts with Medicaid since 2017, which includes $1.2 billion in the emergency contract.

Magnolia is a subsidiary of health giant Centene. The St. Louis-based company is the nation’s largest Medicaid managed care company and one of Gov. Tate Reeves largest campaign donors.

Centene was previously investigated over suspicions it was over-inflating bills to Mississippi’s Medicaid division. The company never admitted wrongdoing, though Centene settled with the state in June of 2021 for $55.5 million.

Medicaid spokesperson Matt Westerfield said there were no “rules that would exclude Magnolia from the process due to the Centene settlement” when asked why, if the company was previously investigated, it was awarded one of the contracts.

Since 2017, Molina has been paid $2.8 billion to provide services for MississippiCAN and Medicaid’s Mississippi Children’s Health Insurance Program, according to the state’s contract database. In the most recent contract, the emergency contract that runs from 2023 until 2024, the company is getting paid more than half a billion dollars.

For the same services in the same time period, United received nearly $8.4 billion. The current emergency contract pays out more than a billion dollars for their services over the course of a year.

Companies involved in the process have seven days to file protests before the agency can officially award the contracts. Then, the contracts go to the state’s procurement review board for final approval.

Following Medicaid’s announcement about the new contracts in August, UnitedHealthcare, which had a contract with the agency the prior year, and Amerigroup, the two companies that were not chosen, submitted protests.

It’s unclear what United’s claims are. Mississippi Today did not have a copy of their protest at the time of publication.

Amerigroup’s protest alleges that Mississippi Medicaid failed to conduct a “blind” evaluation process, didn’t follow the state’s rules for contract procurement, the process was structurally flawed and “outside influences” affected its fairness.

Amerigroup cites several instances where it says companies shared identifying information. According to the protest, TrueCare revealed its connection to the Mississippi Hospital Association by mentioning the health information exchange program, which allows hospitals to share important information about patients with each other. It’s the only company with access to the exchange because of its association with hospitals.

Amerigroup also takes issue with Molina including a company-specific vaccine incentive program, “curved” graphics similar to their logo and “well-known” Molina food insecurity initiatives in its proposal. Magnolia’s proposal included mentions of its partnership with Adelade and AT&T, which would have been enough to identify them, the protest claims.

Magnolia and Molina did not respond to Mississippi Today’s requests for comment regarding these allegations. TrueCare’s CEO Richard Roberson declined to answer questions because “under the Division of Medicaid’s rules, all offerors are prohibited from making public disclosures to the media regarding the procurement.”

The “outside influences” cited by Amerigroup’s protest refers to a letter Sen. Kevin Blackwell, R-Southaven and chairman of the Senate Medicaid Committee, sent to Mississippi Medicaid Executive Director Drew Snyder on Dec. 3, 2021, a few weeks before the procurement process began. Blackwell in the letter vouches for TrueCare and criticizes the performances of the current managed care organizations.

Westerfield said the letter was “never seen by any evaluator, nor was any evaluator made aware that it had even been written.”

“It had no effect on the RFQ process or outcome,” he said.

The protest also includes a screenshot of texts between Drew Weiskopf, a consultant assisting with the evaluation, and Margaret Middleton, a lawyer for Mississippi Medicaid. In the texts, Weiskopf appears to insinuate that the evaluators were able to identify the companies — he refers to their “urge to standup (sic) and shout ‘I know who this is!’” and uses a GIF from the movie Elf in which a character identifies Santa Claus. The texts were allegedly sent during the evaluation meetings scoring the blind proposals.

“The texts do not reflect that any evaluator expressed knowledge of any Offeror, nor could the texts have done so, as no expression was ever made,” Westerfield said.

The Division of Medicaid’s response to the protests, which was to affirm its decision to award the contracts to the three managed care organizations, were issued this past summer. Both organizations appealed the agency’s decision to the procurement review board, and both of those protests are still pending.

As a result of the ongoing complaints, Medicaid extended the contracts of the current managed care organizations — United, Molina and Magnolia — and then issued one-year emergency contracts to them. Those contracts, which began in 2017, will be in place until June 2024.

Violations during the “blind” portion of the process have previously derailed Mississippi Medicaid’s procurement process.

Medicaid Executive Director Drew Snyder told lawmakers at a Senate Medicaid Committee hearing last February that “following the instructions for blind evaluations is one of the perilous spots where procurements can go off the rails.”

“I’m sure more than one agency can share a story of a lengthy procurement that had to be terminated because every vendor revealed some kind of identifying information about itself,” he said.

During a Medicaid procurement for different services two years ago, the agency confirmed that a company’s name appeared in a footnote, which delayed the process.

During the current procurement for managed care contracts, Medicaid said it took several steps to ensure the process was fair, including extensively reviewing submissions, including an independent review by a government office that plays a major role in state procurement processes, which found no problems. The agency also required mandatory training for procurement evaluators, who were “told repeatedly to inform [the Division] if they found any identifying information,” according to the agency.

“No evaluator ever notified DOM that he or she knew the identity of any Offeror, nor did any evaluator make any statement in the evaluation process inferring that he or she knew the identity of any Offeror,” Westerfield said via email.

The fate of the contracts now rests with the procurement review board, which has not yet set a date to hear the protests.

This article first appeared on Mississippi Today and is republished here under a Creative Commons license.

Mississippi Today

Derrick Simmons: Monday’s Confederate Memorial Day recognition is awful for Mississippians

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mississippitoday.org – @BobbyHarrison9 – 2025-04-27 14:32:00

Editor’s note: This essay is part of Mississippi Today Ideas, a platform for thoughtful Mississippians to share fact-based ideas about our state’s past, present and future. You can read more about the section here.


Each year, in a handful of states, public offices close, flags are lowered and official ceremonies commemorate “Confederate Memorial Day.”

Mississippi is among those handful of states that on Monday will celebrate the holiday intended to honor the soldiers who fought for the Confederacy during the Civil War.

But let me be clear: celebrating Confederate Memorial Day is not only racist but is bad policy, bad governance and a deep stain on the values we claim to uphold today.

First, there is no separating the Confederacy from the defense of slavery and white supremacy. The Confederacy was not about “states’ rights” in the abstract; it was about the right to own human beings. Confederate leaders themselves made that clear.

Confederate Vice President Alexander Stephens declared in his infamous “Cornerstone Speech” that the Confederacy was founded upon “the great truth that the negro is not equal to the white man.” No amount of revisionist history can erase the fact that the Confederacy’s cause was fundamentally rooted in preserving racial subjugation.

To honor that cause with a state holiday is to glorify a rebellion against the United States fought to defend the indefensible. It is an insult to every citizen who believes in equality and freedom, and it is a cruel slap in the face to Black Americans, whose ancestors endured the horrors of slavery and generations of systemic discrimination that followed.

Beyond its moral bankruptcy, Confederate Memorial Day is simply bad public policy. Holidays are public statements of our values. They are moments when a state, through official sanction, tells its citizens: “This is what we believe is worthy of honor.” Keeping Confederate Memorial Day on the calendar sends a message that a government once committed to denying basic human rights should be celebrated.

That message is not just outdated — it is dangerous. It nurtures the roots of racism, fuels division and legitimizes extremist ideologies that threaten our democracy today.

Moreover, there are real economic and administrative costs to shutting down government offices for this purpose. In a time when states face budget constraints, workforce shortages and urgent civic challenges, it is absurd to prioritize paid time off to commemorate a failed and racist insurrection. Our taxpayer dollars should be used to advance justice, education, infrastructure and economic development — not to prop up a lost cause of hate.

If we truly believe in moving forward together as one people, we must stop clinging to symbols that represent treason, brutality and white supremacy. There is a legislative record that supports this move in a veto-proof majority changing the state Confederate flag in 2020. Taking Confederate Memorial Day off our official state holiday calendar is another necessary step toward a more inclusive and just society.

Mississippi had the largest population of enslaved individuals in 1865 and today has the highest percentage of Black residents in the United States. We should not honor the Confederacy or Confederate Memorial Day. We should replace it.

Replacing a racist holiday with one that celebrates emancipation underscores the state’s rich African American history and promotes a more inclusive understanding of its past. It would also align the state’s observances with national efforts to commemorate the end of slavery and the ongoing pursuit of equality.

I will continue my legislative efforts to replace Confederate Memorial Day as a state holiday with Juneteenth, which commemorates the freedom for America’s enslaved people.

It’s time to end Confederate Memorial Day once and for all.


Derrick T. Simmons, D-Greensville, serves as the minority leader in the state Senate. He represents Bolivar, Coahoma and Washington counties in the Mississippi Senate.

This article first appeared on Mississippi Today and is republished here under a Creative Commons Attribution-NoDerivatives 4.0 International License.

The post Derrick Simmons: Monday's Confederate Memorial Day recognition is awful for Mississippians appeared first on mississippitoday.org



Note: The following A.I. based commentary is not part of the original article, reproduced above, but is offered in the hopes that it will promote greater media literacy and critical thinking, by making any potential bias more visible to the reader –Staff Editor.

Political Bias Rating: Left-Leaning

This article argues against the celebration of Confederate Memorial Day, stating it glorifies a racist and failed rebellion that is harmful to societal values. It critiques the holiday as a symbol of white supremacy and advocates for replacing it with Juneteenth to honor emancipation. The language used, such as referring to the Confederate cause as “moral bankruptcy,” and the call to replace the holiday reflects a progressive stance on social justice and racial equality, common in left-leaning perspectives. Additionally, the writer urges action for inclusivity and justice, positioning the argument within modern liberal values.

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Mississippi Today

On this day in 1903, W.E.B. Du Bois urged active resistance to racist policies

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mississippitoday.org – @MSTODAYnews – 2025-04-27 07:00:00

April 27, 1903

W.E.B. Du Bois by James E. Purdy in 1907 from the National Portrait Gallery.

W.E.B. Du Bois, in his book, “The Souls of Black Folk,” called for active resistance to racist policies: “We have no right to sit silently by while the inevitable seeds are sown for a harvest of disaster to our children, black and white.” 

He described the tension between being Black and being an American: “One ever feels his twoness, — an American, a Negro; two souls, two thoughts, two unreconciled strivings; two warring ideals in one dark body, whose strength alone keeps it from being torn asunder.” 

He criticized Washington’s “Atlanta Compromise” speech. Six years later, Du Bois helped found the NAACP and became the editor of its monthly magazine, The Crisis. He waged protests against the racist silent film “The Birth of a Nation” and against lynchings of Black Americans, detailing the 2,732 lynchings between 1884 and 1914. 

In 1921, he decried Harvard University’s decisions to ban Black students from the dormitories as an attempt to renew “the Anglo-Saxon cult, the worship of the Nordic totem, the disenfranchisement of Negro, Jew, Irishman, Italian, Hungarian, Asiatic and South Sea Islander — the world rule of Nordic white through brute force.” 

In 1929, he debated Lothrop Stoddard, a proponent of scientific racism, who also happened to belong to the Ku Klux Klan. The Chicago Defender’s front page headline read, “5,000 Cheer W.E.B. DuBois, Laugh at Lothrup Stoddard.” 

In 1949, the FBI began to investigate Du Bois as a “suspected Communist,” and he was indicted on trumped-up charges that he had acted as an agent of a foreign state and had failed to register. The government dropped the case after Albert Einstein volunteered to testify as a character witness. 

Despite the lack of conviction, the government confiscated his passport for eight years. In 1960, he recovered his passport and traveled to the newly created Republic of Ghana. Three years later, the U.S. government refused to renew his passport, so Du Bois became a citizen of Ghana. He died on Aug. 27, 1963, the eve of the March on Washington.

This article first appeared on Mississippi Today and is republished here under a Creative Commons Attribution-NoDerivatives 4.0 International License.

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Mississippi Today

Jim Hood’s opinion provides a roadmap if lawmakers do the unthinkable and can’t pass a budget

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mississippitoday.org – @BobbyHarrison9 – 2025-04-27 06:00:00

On June 30, 2009, Sam Cameron, the then-executive director of the Mississippi Hospital Association, held a news conference in the Capitol rotunda to publicly take his whipping and accept his defeat.

Cameron urged House Democrats, who had sided with the Hospital Association, to accept the demands of Republican Gov. Haley Barbour to place an additional $90 million tax on the state’s hospitals to help fund Medicaid and prevent the very real possibility of the program and indeed much of state government being shut down when the new budget year began in a few hours. The impasse over Medicaid and the hospital tax had stopped all budget negotiations.

Barbour watched from a floor above as Cameron publicly admitted defeat. Cameron’s decision to swallow his pride was based on a simple equation. He told news reporters, scores of lobbyists and health care advocates who had set up camp in the Capitol as midnight on July 1 approached that, while he believed the tax would hurt Mississippi hospitals, not having a Medicaid budget would be much more harmful.

Just as in 2009, the Legislature ended the 2025 regular session earlier this month without a budget agreement and will have to come back in special session to adopt a budget before the new fiscal year begins on July 1. It is unlikely that the current budget rift between the House and Senate will be as dramatic as the 2009 standoff when it appeared only hours before the July 1 deadline that there would be no budget. But who knows what will result from the current standoff? After all, the current standoff in many ways seems to be more about political egos than policy differences on the budget.

The fight centers around multiple factors, including:

  • Whether legislation will be passed to allow sports betting outside of casinos.
  • Whether the Senate will agree to a massive projects bill to fund local projects throughout the state.
  • Whether leaders will overcome hard feelings between the two chambers caused by the House’s hasty final passage of a Senate tax cut bill filled with typos that altered the intent of the bill without giving the Senate an opportunity to fix the mistakes.
  • Whether members would work on a weekend at the end of the session. The Senate wanted to, the House did not.

It is difficult to think any of those issues will rise to the ultimate level of preventing the final passage of a budget when push comes to shove.

But who knows? What we do know is that the impasse in 2009 created a guideline of what could happen if a budget is not passed.

It is likely that parts, though not all, of state government will shut down if the Legislature does the unthinkable and does not pass a budget for the new fiscal year beginning July 1.

An official opinion of the office of Attorney General Jim Hood issued in 2009 said if there is no budget passed by the Legislature, those services mandated in the Mississippi Constitution, such as a public education system, will continue.

According to the Hood opinion, other entities, such as the state’s debt, and court and federal mandates, also would be funded. But it is likely that there will not be funds for Medicaid and many other programs, such as transportation and aspects of public safety that are not specifically listed in the Mississippi Constitution.

The Hood opinion reasoned that the Mississippi Constitution is the ultimate law of the state and must be adhered to even in the absence of legislative action. Other states have reached similar conclusions when their legislatures have failed to act, the AG’s opinion said.

As is often pointed out, the opinion of the attorney general does not carry the weight of law. It serves only as a guideline, though Gov. Tate Reeves has relied on the 2009 opinion even though it was written by the staff of Hood, who was Reeves’ opponent in the contentious 2019 gubernatorial campaign.

But if the unthinkable ever occurs and the Legislature goes too far into a new fiscal year without adopting a budget, it most likely will be the courts — moreso than an AG’s opinion — that ultimately determine if and how state government operates.

In 2009 Sam Cameron did not want to see what would happen if a budget was not adopted. It also is likely that current political leaders do not want to see the results of not having a budget passed before July 1 of this year.

This article first appeared on Mississippi Today and is republished here under a Creative Commons Attribution-NoDerivatives 4.0 International License.

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